Quantifying the effect of shoulder size on operation duration: an analysis of stapes surgery outcomes.

OBJECTIVE: To investigate the effect of body mass index on hearing outcomes, operative time and complication rates following stapes surgery. METHOD: This is a five-year retrospective review of 402 charts from a single tertiary otology referral centre from 2015 to 2020. RESULTS: When the patient's shoulder was adjacent to the surgeon's dominant hand, the average operative time of 40 minutes increased to 70 minutes because of a significant positive association between higher body mass index and longer operative times (normal body mass index group (<25 kg/m2) r = 0.273, p = 0.032; overweight body mass index group (25-30 kg/m2) r = 0.265, p = 0.019). Operative times were not significantly longer upon comparison of low and high body mass index groups without stratification by laterality (54.9 ± 19.6 minutes vs 57.8 ± 19.2 minutes, p = 0.127). CONCLUSION: There is a clinically significant relationship between body mass index and operating times. This may be due to access limitations imposed by shoulder size.

Olfactory-Related Adverse Events: An Analysis of the Food and Drug Administration Adverse Events Reporting System.

OBJECTIVE: Olfactory dysfunction has gained considerable interest with its association to the coronavirus pandemic. Due to the limited literature on olfactory-related adverse events (ORAE) associated with medications, this study investigated ORAE reported in the Food and Drug Administration Adverse Event Reporting System (FAERS) to identify the most frequent medications associated with these reactions. STUDY DESIGN: Cross-sectional analysis SETTING: FAERS database. METHODS: The FAERS database was accessed to obtain ORAEs from 2012 to 2022. Disproportionality analysis was conducted by calculating the proportional reporting ratios (PRR) and reporting odds ratio (ROR) for anosmia, parosmia, hyposmia, and olfactory dysfunction. A PRR > 2 or ROR > 1 was significant. A multivariate logistical model was used to estimate adjusted ROR for gender and country of origin. RESULTS: Our final study population consisted of 1111 cases with the following symptoms: anosmia (672), parosmia (364), hyposmia (71), and olfactory dysfunction (4). The most significant ROR signal scores were found for secukinumab (3.42; 95% confidence interval, CI [1.9, 4.01]) for anosmia, levofloxacin (8.86; 95% CI [2.83, 9.8]) for hyposmia, and pregabalin (6.88; 95% CI [2.23, 8.01]) for parosmia. No significant PRR signal scores were found for anosmia, but significant signals were found for citalopram hydrobromide (17.25; 95% CI [17.01, 17.49]) in hyposmia, and dimethyl fumarate (3.18; 95% CI [3.09, 3.27]) in parosmia. No valid PRR or ROR values were found for olfactory dysfunction. Multivariate analysis did not reveal statistically significant differences between genders for any symptoms, but individuals from non-US countries did exhibit statistically significant elevated risk of anosmia (1.3 (95% CI [1.01, 1.68]). CONCLUSION: Pharmacovigilance studies provide an opportunity to evaluate the safety profile of medications regarding ORAE, particularly for those commonly prescribed for sinonasal symptoms. Findings from this study may function as a resource for prescribers and patients.

Cardiovascular Risk Factors and Sudden Sensorineural Hearing Loss: A Case-Control Study.

OBJECTIVE: To investigate the role of cardiovascular risk factors (specifically hypertension [HTN], hyperlipidemia/dyslipidemia, diabetes mellitus I and II, and body mass index (BMI) on the development of sudden sensorineural hearing loss (SSNHL). STUDY DESIGN: Case-control retrospective chart review. SETTING: A tertiary referral center. PATIENTS: Patients aged 18 to 85 years who presented to the clinic over a 1-year span (September 17, 2020 to September 17, 2021) for evaluation of sudden sensorineural hearing loss. MAIN OUTCOME MEASURE: Comparing the prevalence of the different cardiovascular risk factors (CVRFs) in patients with sudden sensorineural hearing loss compared with when compared with non-SSNHL patients at a neurotology clinic. RESULTS: Two hundred twenty-three patients with SSNHL were compared with age- and gender-matched comparison group to investigate the prevalence of cardiovascular risk factors within each group. There are no statistically significant differences (p > 0.05) in the prevalence of HTN, hyperlipidemia/dyslipidemia, diabetes mellitus I and II, and BMI in patients with sudden sensorineural hearing loss when compared with non-SSNHL patients at a neurotology clinic. CONCLUSIONS: Despite correlation between CVRF and SSNHL found in some other studies, we did not find a significant correlation between CVRF (diabetes, HTN, dyslipidemia, and high BMI) and SSNHL in our retrospective case control study of patients presenting to a nonacademic tertiary neurotology clinic. Although there may be other factors contributing to the pathogenesis of SSNHL, we have not yet identified these factors.

Regulation of Gonad Morphogenesis in Drosophila melanogaster by BTB Family Transcription Factors.

During embryogenesis, primordial germ cells (PGCs) and somatic gonadal precursor cells (SGPs) migrate and coalesce to form the early gonad. A failure of the PGCs and SGPs to form a gonad with the proper architecture not only affects germ cell development, but can also lead to infertility. Therefore, it is critical to identify the molecular mechanisms that function within both the PGCs and SGPs to promote gonad morphogenesis. We have characterized the phenotypes of two genes, longitudinals lacking (lola) and ribbon (rib), that are required for the coalescence and compaction of the embryonic gonad in Drosophila melanogaster. rib and lola are expressed in the SGPs of the developing gonad, and genetic interaction analysis suggests these proteins cooperate to regulate gonad development. Both genes encode proteins with DNA binding motifs and a conserved protein-protein interaction domain, known as the Broad complex, Tramtrack, Bric-à-brac (BTB) domain. Through molecular modeling and yeast-two hybrid studies, we demonstrate that Rib and Lola homo- and heterodimerize via their BTB domains. In addition, analysis of the colocalization of Rib and Lola with marks of transcriptional activation and repression on polytene chromosomes reveals that Rib and Lola colocalize with both repressive and activating marks and with each other. While previous studies have identified Rib and Lola targets in other tissues, we find that Rib and Lola are likely to function via different downstream targets in the gonad. These results suggest that Rib and Lola act as dual-function transcription factors to cooperatively regulate embryonic gonad morphogenesis.