Comparing the Long-Term Stability of Titanium Clip Partial Prostheses with Other Titanium Partial and Total Ossicular Reconstruction Prostheses

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The article is a "standard work" which has been duplicated lots of times comparing novel prostheses with older ones. In all cases, there were no significant differences in the outcomes as there is still ideal prosthesis .

Comparing different PORPs with TORPs is not logical as the biomechanics are different and the extent of treated pathology is also different. You should only compare between similar groups.

You mention that Incus erosion was the commonest ossicular lesion radiologically. How did this correlate with the intraoperative findings [which is more important]?

The statement "There was minimal change in the bone line" should be "minimal change inbone conduction not bone line.

In cholesteatoma patients, was the reconstruction done in the first stage ?

Were was the site of leak in the patient with the perilymphatic fistula and how was it related to the surgery ?

As you demonstrated, both Clips and PORPs have the same short and long term results. When should be choose the costlier and more technically demanding CLIP prosthesis ?

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript titled "Comparing the long-term stability of titanium clip partial prostheses with other titanium PORPs and TORPs" presents a retrospective study evaluating the long-term audiometric stability of various titanium ossicular chain reconstruction prostheses, specifically comparing titanium clip partial prostheses with PORPs and TORPs.

The paper suggests that clip partial prostheses demonstrate comparable or superior long-term stability and surgical success rates when compared to PORPs and TORPs.

General comments: The study adresses the long-term effectiveness of diferent titanium OCR prostheses, an area in which long term follow-up data is missing.

Introduction: In my opinion, it would be beneficial to discuss previous studies that have compared titanium clip partials with PORPs and TORPs. Moreover, I believe that the reason for using titanium clip partial prostheses should be further discussed. Are there any theoretical advantages?

Methods: The authors mention that one of three neurotologists performed the surgeries. Was there any standardization in surgical techniques? If there was no standardization, could this have impacted outcomes?

Results: No comments.

Discussion: No comments

Conclusion: No comments.

I particulary appreciate the final paragraph of the Results section. I would suggest moving it to a study limitations subsection in which to better insist on the small sample size, the loss to follow-up of 15 patients which is more than half of the total number of patients. Furthermore, as with all restrospective studies, the nature of this study introduces bias, as data collection relies on existing medical records, which may lack uniformity in documentation.

Nevertheless, no study is perfect, and I acknowledge that my comments are strictly subjective. I do not believe it is absolutely necessary to address all these concerns. I recommend publishing the manuscript in its current form. 

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for properly addressing the issues which were raised.