OTOL1 and primary hyperparathyroidism: It was also found that both parathyroid hormone and total calcium levels affect the otolin-1 levels of patients with primary hyperfunction of parathyroid, suggesting that calcium dysregulation caused by primary hyperparathyroidism may contribute to otolith catabolism by affecting Otolin-1 levels, and may be associated with inner ear diseases such as BPPV (Mckenna et al., 2020).