Cochlear Implantation Following Neurobrucellosis-Related Bilateral Profound Sensorineural Hearing Loss: A Case Report and Literature Review

Brucellosis is the most common bacterial zoonosis worldwide, and neurological involvement - neurobrucellosis - can cause bilateral profound sensorineural hearing loss (SNHL) that does not respond to antibiotic therapy. We report cochlear implantation (CI) outcomes in a 60-year-old man with confirmed neurobrucellosis who developed bilateral profound SNHL that provided no functional benefit after a six-month binaural hearing aid trial. Preoperative temporal bone computed tomography and magnetic resonance imaging confirmed intact cochlear anatomy with no labyrinthitis ossificans on either modality. Right-ear CI was performed after an infectious disease consultation confirmed sustained disease remission. At 12-month follow-up, sound-field thresholds were 40 dB hearing level (HL) at 500 Hz and 45-50 dB HL at 1,000-4,000 Hz. The patient was able to follow face-to-face conversations without lip-reading. We also review all previously published cases in which CI was performed or considered in this setting, highlighting the consistent absence of labyrinthitis ossificans, unlike most other bacterial causes of deafness, which facilitates full electrode insertion and supports favorable outcomes. CI is safe and effective for neurobrucellosis patients with bilateral profound SNHL, and confirmed disease remission before surgery is a mandatory prerequisite.