Comparison of Cartilage Conduction Hearing Devices Designed by Ear Impression and Computed Tomography

Round 1

Reviewer 1 Report (Previous Reviewer 1)

All my previous concerns have been addressed adequately.  The manuscript could be published in its present form.

Reviewer 2 Report (Previous Reviewer 3)

When I examine the text of the last revision and the responses to criticism, I see that the authors better express the purpose of the article. As stated by the authors, it may be an alternative to the traditional method in patients with aural atresia who have pre-existing CT images. Acceptance of the article is appropriate, with the editor's discretion with the latest corrections.

Kind regards

Reviewer 3 Report (Previous Reviewer 4)

The authors have taken into account the comments and suggestions provided. The manuscript is much more clearly constructed, the results are presented in more detail and importantly, the discussion and conclusions part is well dissected and discussed and presents the results of the study in a concrete way. As such, I propose the manuscript for publication.

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.

Round 1

Reviewer 1 Report

In this manuscript, Nishimura et al. reported the usefulness of the CT-based design of the cartilage conduction hearing aid shell shape. The study design is appropriate, and the significance of the study would be of interest to the readers.

Several points should be addressed for the improvement of this manuscript.

 

Major point)

While otologists or audiologists could easily imagine the process of this study, most readers would not understand the difference between the ear impression and CT-based design. Therefore, an illustration figure showing the whole process of this study would be useful for the reader. For example, how to take ear impression and make a CT-based design should be shown in the illustration would be beneficial.  

 

Minor Point)

1)L51-L71

A previous study comparing BAHA, ADHEAR, and CC hearing devices would be helpful for the introduction in this section. Please consider making a discussion and citing the study below.

 

Kitama et al. Comparison of Cartilage Conduction Hearing Aid, Bone Anchored Hearing Aid, and ADHEAR: Case Series of 6 Patients with Conductive and Mixed Hearing Loss, 2022

 

 

2)Reference list should be checked again; the reference number is dabbling.

Reviewer 2 Report

Although the manuscript sounds interesting, I can see too many methodological flaws. The sample is unbalanced and very small, and, thus, I cannot believe that it is possible to make conclusions based on the data collected. Moreover, the introduction does not sufficiently rely on the latest literature in the field. Likewise, the discussion is poor, the findings are not explained with the existing literature. Conclusions are too general and the text is absolutely too short and does not tell anything concrete.

Reviewer 3 Report

In their study, the authors compared hearing aids created by software that analyzes CT images in patients with aural atresia, with hearing aids made with the traditional method. As a result of the study, they stated that the devices obtained using CT images do not have a functional and aesthetic superiority over the hearing aids obtained by the traditional method. As the authors mentioned in a part of the article, the creation of a hearing aid with CT is not a very acceptable procedure, both in terms of radiation to the patient and financially. Although the article is well written in general, I unfortunately do not think that the study will shed a new perspective or light on the literature.

Cartilage conductive auditory pathway has been described in recent decades as an auditory pathway that is different from the air and bone pathways. However, the acoustic details of how this hearing pathway works and how the hearing aids used in this way work are not yet clear. And as far as I know, this type of hearing aids is seen as a device model that has not yet been fully accepted in the world and is not widely used. In my opinion, it would be more beneficial for articles on this subject to better illuminate this auditory pathway.

Additional suggestions to the article;

1- The Introduction section is very long, I think it would be appropriate to remove some parts and give information about the cartilage conduction hearing path.

2- The details of the questionnaire made to the patients should be shared in the method section. To make the study design a little clearer, the net usage time of the devices and whether patients know which device they are using should be stated. In addition, the low number of patients may not have allowed a clearer assessment.

3- In the Discussion section, the literature information on this subject, if any, should be discussed.

 

Reviewer 4 Report

The authors proposed the following manuscript: "Comparison of cartilage conduction hearing devices designed 2 by ear impression and computed tomography". Although the manuscript is well written and structured, too few qualitative as well as quantitative results are presented. The number of patients (3) is almost irrelevant to the study. The findings do not reveal anything new in the research in this field. I strongly suggest rewriting this study.