OK-432 Treatment of Ranula Intruding into the Cervical Region

Round 1

Reviewer 1 Report

The manuscript addresses the interesting topic of the treatment of plunging ranula. The authors described 8 cases treated with OK-432. However, case presentation is insufficient and overall the authors are required to address the following issues:

• The introduction is extremely succinct. The authors should further describe the rationale behind the use of OK-432, and also further address alternative treatment protocols for ranula management.
• Methods: How was diagnosis performed? Why treatment with OK-432 was chosen? Did the patients have any symptoms? How was the lesion's dimension evaluated? How was follow-up scheduled? What was the maximum follow-up period?
• Methods: statement on ethical approval is missing
• Results: Please organize this section in order to 1) identify baseline sample size characteristics; 2) report treatment administration and side effects; 3) describe treatment outcomes at follow-up.
• Results. MR images can be seen in this section. Why did the authors choose MR over other techniques? Why ultrasonography could not be used?
• Discussion: As for the introduction, this section does not provide sufficient comparison with current literature. This section needs to be implemented.
• Figures: figure quality is low and the images are shrunk. Please consider re-sizing.

Author Response

I attached the comments to reviewer.  

Author Response File: Author Response.doc

Reviewer 2 Report

Interesting subject and manuscript.

Aims and conclusions are well presented.

Methodology is not clear to me. Eligiblity, inclusion and exclusion criteria are not clearly stated. Consecutive patients? Seems to have both children and adults included?

Output measures seem to be subjective?

Sclerotherapy technique poorly described. Maybe with picture/ drawing? Imaging photos don´t seem to be so useful.

There are other sclerotherapy studies larger than this. They should be accounted and compared to.

Discussion is quite poor. More a restatement of results than a true discussion.

Author Response

I attached the files to reviewer's comments.  

Author Response File: Author Response.doc

Round 2

Reviewer 1 Report

The authors partially addressed the comments raised in the previous revision. However, there are some additional comments:

• Introduction: please structure the introduction as it follows: epidemiology, histological characteristics, diagnosis, treatment, study aims.
• Methods: "The diagnosis of ranula was confirmed by clinical symptoms, MRI and histopathological analysis": was an incisional biopsy performed? Please report in detail the diagnostic work-up - e.g. clinical presentation, differential diagnosis, diagnostic work-up.
• Results: how was size reduction measured? Please clarify if the measurements were performed with MR, and describe the technique employed and the software used.
• Discussion section is still limited and does not appropriately compare the findings with current literature. Please implement this section. 

Author Response

I attached the file.

Author Response File: Author Response.doc

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.