Cochlear Implantation in Intralabyrinthine Schwannoma: Case Series and Systematic Review of the Literature

Round 1

Reviewer 1 Report

This work is confusing as its title does reflect the content of the manuscript. The concern is not about intracochlear schwannomas (ICS) and the outcomes of cochlear implantation but cochlear performance in intralabyrinthine schwannomas (ILS) whether the cochlea was invaded or not! ! Rather than to indicate than seven extensions are possible within the labyrinth, it would have been more informative to separate those tumours invading strictly the cochlea totally or partly, from those invading (i) strictly the vestibule  (iii)  both the cochlea and the vestibule, (iv) the internal auditory meatus, (v) the cerebello-angle, (vi) the middle ear. In table 1, it is not clear how many had no extension into the cochlea, as well as in the literature review; Would it be possible than rather to describe series by published series, to make a synthesis of what have been done in function of the tumour extension and hearing loss on both sides ? Further in many cases of ILS, they are NF2-related schwannomas which is a much complex situation than sporadic schwannomas; So this should described and it should be discussed what the decision-making considering NF2 patients ? All these information should be included in Table 1.

In case 1: Indicate which kind of radiotherapy

In case 2: What is the difference between neurosensorial  and sensorineural hearing loss , please simplify ! "Tympanic scala" is unusual, scala tympani is better ! 

Author Response

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Reviewer 2 Report

The paper may be published, even if, as stated by the  Authors, for the heterogeneus data and the low level of evidence it is impossible to reach any conclusions. Minor modifications are required: 1) the term "petrosectomy" and "lateral petrosectomy"should be changed in "subtotal petrosectomy", in agreement with the original description by Fisch in 1988; 2) on page 6 the term "translabyrinthine " is used when it could be more appropriate to define the approach a labyrintectomy, because removal of intralabyrinthine tumors  does not require to expose the internal auditory canal; 3) the Author should explain the selection of the array in their 2 new cases (theoretically a stiffer array could offer some advantages in the contest of an intracochlear schwannoma or after a partial drilling of the cochlea).

The term subtotal

Author Response

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Round 2

Reviewer 1 Report

The revision has been made adequately;

One correction in a red corrected paragraph of case 2: our instead of aour 

Author Response

Response to Reviewer 1 Comments

Thank you for your revision, we corrected it in the text.

Author Response File: Author Response.docx