Review Reports

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript titled "Case Report and Literature Review on Tongue Schwannoma" presents a comprehensive overview of a rare neoplasm affecting the tongue. The authors have combined a detailed case report with an extensive literature review, enhancing the understanding of the clinical manifestations, surgical management, and outcomes of tongue schwannoma. The methodology for the literature review is robust, and the case report is well-documented with clinical, radiological, and histological findings. However, some areas require clarification and improvement to strengthen the manuscript further.

1.       The current title is descriptive but could be improved to reflect the systematic review and individual patient data analysis effort. A suggested title could be "Systematic Review and Individual Patient Data Analysis of Tongue Schwannoma: Case Report and Literature Review."

2.       The abstract is concise and provides a good summary of the case report and literature review. However, it would benefit from a brief mention of the key findings from the literature review, such as the most common presentation and preferred surgical approaches.

3.       The review covers a wide range of cases, providing valuable insights into the demographics, clinical presentations, and management of tongue schwannomas. However, the section would benefit from more critical analysis and comparison of the findings across different studies.

4.       The tables summarizing the literature review are comprehensive and well-organized. However, it would be beneficial to include a summary table highlighting the key findings and trends observed in the reviewed cases. The large table could be moved to the supplementary section to improve readability.

5.       the authors should discuss potential limitations of their review and suggest directions for future research.

 

6.       There are several typographical and grammatical errors throughout the manuscript. For instance, 'capslue' should be corrected to 'capsule,' and 'Image 5' should be corrected as 'S100 positivity.' A thorough language and grammar check is necessary to enhance the manuscript's professionalism.

Comments on the Quality of English Language

 thorough language and grammar check is necessary to enhance the manuscript's professionalism.

Author Response

Comment 1: The current title is descriptive but could be improved to reflect the systematic review and individual patient data analysis effort. A suggested title could be "Systematic Review and Individual Patient Data Analysis of Tongue Schwannoma: Case Report and Literature Review."

Response 1: I much appreciate the suggestion, but I though to use a shorter title to ensure the best readability possible

Comment 2: The abstract is concise and provides a good summary of the case report and literature review. However, it would benefit from a brief mention of the key findings from the literature review, such as the most common presentation and preferred surgical approaches.

Response 2: Thank you for this observation, the abstract has been updated with the most common presentation and surgical approach, also the portion describing the methods was reduced.

Comment 3: The review covers a wide range of cases, providing valuable insights into the demographics, clinical presentations, and management of tongue schwannomas. However, the section would benefit from more critical analysis and comparison of the findings across different studies.

Response 3: Much appreciated observation, the discussion has been updated, but surely a much deeper critical anlysis could be possible.

Comment 4: The tables summarizing the literature review are comprehensive and well-organized. However, it would be beneficial to include a summary table highlighting the key findings and trends observed in the reviewed cases. The large table could be moved to the supplementary section to improve readability.

Response 4: Thank you for the suggestion, the table was moved to the supplementary section.

Comment 5: the authors should discuss potential limitations of their review and suggest directions for future research.

Response 5: I much appreciate the suggestion, the section regarding strenghts and limitations of this study in the conclusions.

Comment 6: There are several typographical and grammatical errors throughout the manuscript. For instance, 'capslue' should be corrected to 'capsule,' and 'Image 5' should be corrected as 'S100 positivity.' A thorough language and grammar check is necessary to enhance the manuscript's professionalism.

Response 6: Thank you for pointing out, the various typographical and grammatical errors were corrected

Reviewer 2 Report

Comments and Suggestions for Authors

I appreciate the Authors' effort to explore the topic since it is relevant in routine clinical practice. However, the paper has serious flaws that preclude its publication in its current form. Extensive native-speaker English editing is required due to numerous grammatical, punctuation, and stylistic errors (e.g., Line 9 - "It usually presents as a benign behaviour", Line 11 - "In this article is reported the case", Line 11 – "a man presenting an asymptomatic mass", Line 18 – "An additional 19 articles", Line 35 – "constituite", Line 42 "capslue" etc.), some of which make the text difficult to comprehend. The entire manuscript should be checked in this respect.

 Additionally, I have the following suggestions, which should be considered:

Abstract

1.      The abstract contains too detailed information about the methodology of the literature review, while it does not present any results stemming from the included studies. Please correct and rewrite the abstract.

Introduction

2.      Line 31 ("coding for") – Did you mean "encoding"? Please correct.

3.      Line 35 ("Schwannomas constituite between 25 and 45 percent of neoplasms of head and neck") - This statement is false. More than 90% of tumours in the head and neck region are squamous cell carcinomas. Did you mean that 25–45% of all reported schwannomas were found in the head and neck region? Please correct.

4.      The fragment from line 47 to line 53 is difficult to comprehend. Please rewrite the paragraph.

5.      Line 47 ("blood trobized vessels") - Such a statement does not exist. Please clarify and correct in the manuscript.

6.      Line 54 ("GFAP") – All abbreviations should be explained in the text at first mention.

7.      The description of all the histological nuances regarding schwannomas seems too detailed. Please rewrite the introduction section.

Detailed Case Description

8.      Line 65 ("He sought attention") – This statement is informal and incorrect; please rephrase it.

9.      Line 68 ("clinical elements") - This statement is vague; please clarify in the manuscript.

10.  Lines 71-72 ("a contrast enached RMI") – Did you mean "contrast-enhanced MRI"? Please correct. Additionally, all abbreviations should be explained in the text at first mention.

11.  Line 79 – Please provide the exact duration of the follow-up period.

Images

12.  Please use the term "Figures" instead of "Images".

13.  Figures 1 and 3 are the same. Please correct.

14.  Did you mean "coronal view" instead of "frontal view"? Please correct.

15.  All figure titles should describe what can be seen in the figure, not merely the MRI sequence and plane.

Table 1

16.  Due to the length of Table 1, I suggest including it in the Supplementary materials instead of the main text. In the present form, Table 1 is longer than the entire manuscript text. Additionally, all abbreviations used in the Table should be explained in the Table legend.

Discussion

17.  Line 145 - What did you mean by "preoperative study"? This statement is vague; please clarify in the manuscript.

18.  Lines 154-155 ("supraioid", "transioid") – Did you mean "suprahyoid" and "transhyoid"? Please correct in the text.

19.  Line 162 - What did you mean by "preoperative controls"? This statement is vague; please clarify and correct it in the manuscript.

Conclusions

20.  The conclusion section is too lengthy and detailed. It should be concise and to the point. Please rewrite this fragment.

21.  Lines 186-188 ("The findings of this review confirm that tongue schwannoma predominantly affects individuals between the third and fifth decades of life, with a similar incidence among both sexes") - This sentence means the same as the one at the beginning of this section (lines 168-170) and constitute an unjustified repetition. I suggest removing it.

22.  Lines 191-196 – I suggest transferring this fragment to a separate paragraph under the title "Strengths and limitations" and completing the section with the limitations of the present study.

In summary: Despite the topic's relevance in clinical practice, the manuscript has significant shortcomings, which the Authors should address to raise the scientific level of the paper. Along with correcting the existing mistakes, many vague statements need clarification to facilitate the comprehension of the manuscript. The introduction section needs to be rewritten, while the conclusions section needs to be rephrased – in the present form, it does not differ from the discussion itself.

Comments on the Quality of English Language

Extensive native-speaker English editing is required due to numerous grammatical, punctuation, and stylistic errors, some of which make the text difficult to comprehend. The entire manuscript should be checked in this respect.

Author Response

Comment 1: The abstract contains too detailed information about the methodology of the literature review, while it does not present any results stemming from the included studies. Please correct and rewrite the abstract.

Response 1: Thank you for your observation, the description of the method was reduced, also the most common presentations and surgery were reported.

Comments 2 - 6, 8 - 10, and 18: 2 Line 31 ("coding for") – Did you mean "encoding"? Please correct. 3.      Line 35 ("Schwannomas constituite between 25 and 45 percent of neoplasms of head and neck") - This statement is false. More than 90% of tumours in the head and neck region are squamous cell carcinomas. Did you mean that 25–45% of all reported schwannomas were found in the head and neck region? Please correct. 4.      The fragment from line 47 to line 53 is difficult to comprehend. Please rewrite the paragraph. 5.      Line 47 ("blood trobized vessels") - Such a statement does not exist. Please clarify and correct in the manuscript. 6.      Line 54 ("GFAP") – All abbreviations should be explained in the text at first mention. 8.      Line 65 ("He sought attention") – This statement is informal and incorrect; please rephrase it. 9.      Line 68 ("clinical elements") - This statement is vague; please clarify in the manuscript. 10.  Lines 71-72 ("a contrast enached RMI") – Did you mean "contrast-enhanced MRI"? Please correct. Additionally, all abbreviations should be explained in the text at first mention. 18.  Lines 154-155 ("supraioid", "transioid") – Did you mean "suprahyoid" and "transhyoid"? Please correct in the text.

Response 2 - 6, 8 - 10, and 18: I much appreciate your observations, the English was overall revised.

Comment 7: The description of all the histological nuances regarding schwannomas seems too detailed. Please rewrite the introduction section.

Response 7: Thank you for your opinion, the section was reduced and the description of the reported histological variables were inserted in the discussion session.

Comment 11: Please provide the exact duration of the follow-up period.

Response 11: I appreciate your observation, the duration of the follow up was provided, also, a session regarding the follow-up periods reported in the articles obtained in the review was added.

Comment 12 - 15: Please use the term "Figures" instead of "Images".  Figures 1 and 3 are the same. Please correct.  Did you mean "coronal view" instead of "frontal view"? Please correct. All figure titles should describe what can be seen in the figure, not merely the MRI sequence and plane.

Response 12 - 15: Thank you for noticing, the captions were updated.

Comment 16: Due to the length of Table 1, I suggest including it in the Supplementary materials instead of the main text. In the present form, Table 1 is longer than the entire manuscript text. Additionally, all abbreviations used in the Table should be explained in the Table legend.

Response 16: The table was included in the supplementary materials and the abbreviation N/A was explained as: “Not reported / Absent”

Comments 18, 19: Line 145 - What did you mean by "preoperative study"? This statement is vague; please clarify in the manuscript. Line 162 - What did you mean by "preoperative controls"? This statement is vague; please clarify and correct it in the manuscript.

Response 18, 19: I appreciate your observation, the statements were specified

 Comment 20, 22: The conclusion section is too lengthy and detailed. It should be concise and to the point. Please rewrite this fragment.Lines 191-196 – I suggest transferring this fragment to a separate paragraph under the title "Strengths and limitations" and completing the section with the limitations of the present study.

Response 20, 22: I appreciate your observation, the conclusion was reduced and rephrased, also it was divided in sections for clarity and the limitations of the study was added.

Comment 21: Lines 186-188 ("The findings of this review confirm that tongue schwannoma predominantly affects individuals between the third and fifth decades of life, with a similar incidence among both sexes") - This sentence means the same as the one at the beginning of this section (lines 168-170) and constitute an unjustified repetition. I suggest removing it.

Response 21: Thank you for noticing, the second sentence was removed

Reviewer 3 Report

Comments and Suggestions for Authors

Dear Authors,

I read with great interest your manuscript about tongue schwannoma.

However, there are some aspects that require your attention.

Table 1 caption, please correct pubmed with PubMed.

Figure 1, insert also the values on each column.

Figure 3, insert also the values not only the percentage.

Figure 4, insert also the values on each column.

For the Informed Consent Statement: please provide the informed consent of the patient that you presented.

looking forward to receiving the improved version of your manuscript.

Author Response

Comments 1: " Table 1 caption, please correct pubmed with PubMed."

Response: Thank you for pointing out, the table was separated from the main text for clarity and its caption has been corrected

Comments 2-5: " Figure 1, insert also the values on each column. Figure 3, insert also the values not only the percentage. Figure 4, insert also the values on each column. "

Response: Thank you for noticing, the values are now present, also the term "Figure" was changed in "Graph"

Comments 5: "For the Informed Consent Statement: please provide the informed consent of the patient that you presented."

Response: Thank you for pointing out, the providing of the informed consent is now reported

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors have addressed all my concerns

Comments on the Quality of English Language

Language is fine

Author Response

Thank you for your attention and your approval.

Reviewer 2 Report

Comments and Suggestions for Authors

I greatly appreciate the Authors’ effort to raise the scientific level of the manuscript. The manuscript deserves acceptance if the following shortcomings are corrected:

1.      The numbering of the charts does not match the numbers in the text (e.g., Line 339  - “In 36 cases (19.4%) (Graph 2), patients were 16 years or younger” – While the graph showing the age distribution of patients is number 2. This comment also applies to the remaining graphs; please correct.

2.      Since the “Strength and limitations” section usually belongs to the discussion itself and not the conclusions, I suggest moving paragraph 4.2. to the discussion section. Furthermore, I suggest merging the first and third sections (“Summary of findings” and “Further research”) and placing the text under the title “Conclusions” so that this section does not contain subsections.

Author Response

Comments 1 and 2: The numbering of the charts does not match the numbers in the text (e.g., Line 339  - “In 36 cases (19.4%) (Graph 2), patients were 16 years or younger” – While the graph showing the age distribution of patients is number 2. This comment also applies to the remaining graphs; please correct. Since the “Strength and limitations” section usually belongs to the discussion itself and not the conclusions, I suggest moving paragraph 4.2. to the discussion section. Furthermore, I suggest merging the first and third sections (“Summary of findings” and “Further research”) and placing the text under the title “Conclusions” so that this section does not contain subsections.

Response: Thank you for your attention and precision, your suggestions have been implemented in the paper.