The Otoprotective Effect of Ear Cryotherapy: Systematic Review and Future Perspectives

Round 1

Reviewer 1 Report

The study "The otoprotective effect of ear cryotherapy: systematic review and future perspectives" is exploring literature database in te field of protective effect of hypothermia on inner ear function of hearing. Overall, the topic taken up by the authors is interesting, however the manuscript requires extensive corrections. The impression is that the manuscript was prepared in a hurry, neglecting both language and merit.

Introduction:

It delivers the scientific and clinical context of the study widely and properly, showing a list of relevant references. However, the text starting from line 77 most probably was incorporated by accindet to the manuscript?

Methods:

line 81- is January 2021 correct?

The Fig 1 seems OK, however, as seen in the Results section, papers showing hyperthermia effect on inner ear shoud not be included into the study, as of  the aim of the current review was to assess only the hypothermia effect on hearing.  

Results:

Lines 147-149 - the text simply repeats the content of Fig 1.

lines 150-154 - the text sould be included into the Fig 1

Where is Table 1?
 This chapter should be well structured, with separated paragraphs and their subtitbles.  In the current form it is difficult to follow the authors thought.

Table 2- Mause is a german word, in english it is mice; "CI implantation" - shoudl be just CI, or cochlear implantation

As mentioned before - hyperthermia does not fall into the scope if this review (Table 2)

line 182-  instead of "preemptive" should be "pre-emptive"

When referring to the reviewed papers authors should report on their methodology more profoundly. Authors use very imprecise expressions, like in line 199 "hearing level recovered to that of the intact ear" but do not provide any methodology how the euqality of levels was assessed. Analogically in line 208-209 " The otroprotective effect was observable in objective audiometry and under electron microscopy"- a semantic mistake.   The same applies to lines 229-230, 231-232, 248-249.

Many selling mistakes, like in lines 247, 251-252, to show just e few out of many more.

Discussion:

The authors present scientific value and possible clinical apllication of reviewed papers. This chapter is structured better than the previous ones, and the message seems to be clear. However, still numerous grammar and style mistakes need to be corrected. 

Author Response

Please consider the attached File

Author Response File: Author Response.pdf

Reviewer 2 Report

Cryotherapy in otology has been under-reported and not sufficiently researched. It is a merit oft this literature review to raise awareness of cryotherapy and its application in otology and particularly its potential benefit in hearing protection.

While the merit is in no doubt the paper reads more like a draft that requires editing. The title claims a demanding systematic review, but in the end turns out to be a simple compilation of relevant publications. 

The Abstract is reasonable.

In the Introduction we are reminded that the pathophysiology of inner ear disorders is generally not understood and that a better understanding did not lead to better treatment outcomes. Available therapies have had mixed results and in some cases ended in  adverse effects. It was therefore natural to seek other treatment modalities. Cryotherapy as a new form of treatment seems to fill an important gap, at least for the protection of hearing as e.g. is required during ototoxic chemotherapy.

There is no need to waffle about it and extend the text with irrelevant information such as Barany's achievements. Instead we would expect that the introductory text is followed by an explanation why this systematic review was conducted. This is missing. In addition we are made to believe that key topics are being addressed later in the paper, which in the end is nowhere to be found.

The text 77-86 seems to be completely out of context. It appears that an uncorrected draft had been submitted.

The Method is clear, however, parts of the Method are found in the Results where they do not belong.

In the Results we miss a clear break down between general findings and specific findings. There is a lack of categorisation. Proper highlighted subtitles would help a reader's orientation.

In the Discussion the opportunity is lost to answer specific key questions allured to in the introduction. A critical discourse of theories that might lead to future research has not been attempted.

The Conclusions are too long and should not be an extension of the discussion.

Overall this paper addresses an interesting topic, but it does not deliver what it promises.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

This is a well revised paper and deserves publication.