Geometric–Statistical Model for Middle-Ear Anatomy and Ventilation

Round 1

Reviewer 1 Report

The presented work addresses a very basic anatomical question. However, the authors did not provide enough sufficient background from anatomical point of view to describe the problem. From modelling point of view, the authors do not address the effect of huge geometrical simplification that was made. It would be great if authors could show the regions from histology images or CT images and justify the simplifications. There are multiple sentences in the methods and results section which are stating the reasoning behind the choices were made during modeling, which all could be addressed in discussion section. Also, conclusion section should clearly address the objectives of the study using the results, instead of adding more questions without answers.

Author Response

The presented work addresses a very basic anatomical question.

However, the authors did not provide enough sufficient background from anatomical point of view to describe the problem.

R: our study is a theoretical interpretation of current anatomic and physiologic data and sets the premise for new research based in histology and imagery (CT-scan). You should also bare in mind that this approach to the problem has never been performed. The two organs in the ME have been defined by the authors of this work in a previous article. No one else has had this idea before.

 

From modelling point of view, the authors do not address the effect of huge geometrical simplification that was made. It would be great if authors could show the regions from histology images or CT images and justify the simplifications.

 

R: the simplification was necessary in order to define the structures. The clinical relevance is stated in /conclusions and will be even more evident after the follow-up articles based on histology and imagery. We think that the present work sets the basis for very interesting further research both from us and other colleagues. We try to define a new paradigm on middle-ear pathology, physiology and anatomy. We would greatly appreciate the chance to make our work visible for other researchers and maybe take this matter further.

 

 

There are multiple sentences in the methods and results section which are stating the reasoning behind the choices were made during modeling, which all could be addressed in discussion section.

 

R: could you please be more specific about this suggestion? Thank you!

Also, conclusion section should clearly address the objectives of the study using the results, instead of adding more questions without answers.

R: the conclusion section has been totally restructured and the questions eliminated as suggested by several reviewers.

 

Author Response File: Author Response.docx

Reviewer 2 Report

1. The introduction in the abstract is too long.... Moreover, stating the questions you going to answer is great but I would really be happy to also get the answers right after. At least in a sentence.
2. "Based on physical laws" - can be removed.
3. The problem definition is shown in the first few sentences in Section 2 and should be in Section 1.
4. It is not clear when the presented parameter values are cited or obtained. Please be clear when you cite from another study and obtained this data in another way.

* As a mathematician, the mathematics are simple but appropriate to the paper and I did not spot any mistakes. 

* Fig 2 is well made.

Author Response

1. The introduction in the abstract is too long.... Moreover, stating the questions you going to answer is great but I would really be happy to also get the answers right after. At least in a sentence.

R: The abstract has been shortened and reorganized. The questions have been taken out of the Abstract but we would prefer to keep them at least once in the main text since they help us underline our point and create a premise.

2. 
   "Based on physical laws" - can be removed. - Done
   3. The problem definition is shown in the first few sentences in Section 2 and should be in Section 1. – Done as suggested.
   4. It is not clear when the presented parameter values are cited or obtained. Please be clear when you cite from another study and obtained this data in another way. – The parameter values are mainly obtained from previous studies, cited in text. Everything else is a purely theoretical interpretation of the data but in sets the premise for very exciting further research based on histology, imagery and anatomy data. We try to define a new paradigm on middle-ear pathology, physiology and anatomy. We would greatly appreciate the chance to make our work visible for other researchers and maybe take this matter further.
   
   * As a mathematician, the mathematics are simple but appropriate to the paper and I did not spot any mistakes. 

We appreciate the kind words since none of us is a mathematician and we put a lot of work into providing the data.

* Fig 2 is well made. – thank you! It means a lot to us.

Author Response File: Author Response.docx

Reviewer 3 Report

Marian Rădulescu et al. proposed a geometric model considering the middle ear's main parts to better explain the anatomical details in the Otology field. Overall, this manuscript seems unsuitable for publication and needs to address significant revisions. Some concerns must be clarified, and the manuscript must be better written.

 

First, the abstract is too long and needs a reorganization of the ideas, and you must be as shorter as you can, highlighting important information about the present research. Avoid using questions, and share the innovation and solution of your work.

 

It would help if you rewrote the whole introduction. Lines 88 to 191 need to be moved to the introduction; in the last paragraph of the introduction, authors should highlight the way the present study is novel regarding other of the same topic in the literature. The novelty is not well emphasized. Again, please do not include questions in your manuscript.

 

There is no methodology section, and it must be considered as detailed as possible. The main text's design requirements must be moved to the material and methods section. There is much information about the mathematical process. It would help if you considered only relevant equations.

 

 

 Discussion section: How do your results compare to other researchers? How are these results clinically relevant? Are there any clinical trials using some of these designs that you are proposing with associated data?

 

The conclusion is not clear at all. You must rewrite this section. Also, the whole article is too long, and in some parts, interest is lost. Finally, there are grammar and style errors throughout the paper: suggestions are attached in the file.

 

 

The aim of the present work, a geometric model of the anatomical parts of the middle ear as a tool explaining the main features of the child to adult anatomy, is essential and exciting from a mathematical perspective. 

Comments for author File: Comments.pdf

Author Response

Marian Rădulescu et al. proposed a geometric model considering the middle ear's main parts to better explain the anatomical details in the Otology field. Overall, this manuscript seems unsuitable for publication and needs to address significant revisions. Some concerns must be clarified, and the manuscript must be better written.

 

First, the abstract is too long and needs a reorganization of the ideas, and you must be as shorter as you can, highlighting important information about the present research. Avoid using questions, and share the innovation and solution of your work.

R: The abstract has been shortened and reorganized. The questions have been taken out of the Abstract but we would prefer to keep them at least once in the main text since they help us underline our point and create a premise.

 

It would help if you rewrote the whole introduction. Lines 88 to 191 need to be moved to the introduction; in the last paragraph of the introduction, authors should highlight the way the present study is novel regarding other of the same topic in the literature. The novelty is not well emphasized. Again, please do not include questions in your manuscript.

R: We have tried to comply with your suggestions but we would prefer to keep the present structure. The novelty of the study has been explained in some new paragraphs.

 

 

There is no methodology section, and it must be considered as detailed as possible. The main text's design requirements must be moved to the material and methods section. There is much information about the mathematical process. It would help if you considered only relevant equations.

 

 R: our study is a theoretical interpretation of current anatomic and physiologic data and sets the premise for new research based in histology and imagery (CT-scan). You should also bare in mind that this approach to the problem has never been performed. The two organs in the ME have been defined by the authors of this work in a previous article. No one else has had this idea before.

 

 Discussion section: How do your results compare to other researchers? How are these results clinically relevant? Are there any clinical trials using some of these designs that you are proposing with associated data?

R: again, they do not compare since no other author had this approach before. The best we can do is try some comparison to loosely similar work. The clinical relevance is stated in /conclusions and will be even more evident after the follow-up articles based on histology and imagery.

 

 

The conclusion is not clear at all. You must rewrite this section. Also, the whole article is too long, and in some parts, interest is lost. Finally, there are grammar and style errors throughout the paper: suggestions are attached in the file.

R: We are very grateful for your suggestions, especially in the language part since none of us is a native English speaker. We have reorganized the Conclusions and also provided a certificate of English proofing from a certified translator in Romania.

 

 

 

The aim of the present work, a geometric model of the anatomical parts of the middle ear as a tool explaining the main features of the child to adult anatomy, is essential and exciting from a mathematical perspective.

 

R: We agree and we think it sets the basis for very interesting further research both from us and other colleagues. We try to define a new paradigm on middle-ear pathology, physiology and anatomy. We would greatly appreciate the chance to make our work visible for other researchers and maybe take this matter further.

 

 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

The authors edited the manuscript and the new version is better. However, in my humble opinion it is still hard to follow. Such paper could have been formatted more approperiately for a wider audience. 

Author Response

The authors edited the manuscript and the new version is better. However, in my humble opinion it is still hard to follow. Such paper could have been formatted more approperiately for a wider audience. 

 

R: We appreciate the new evaluation and we do agree that the entire subject is rather complicated and difficult to follow for non-specialists. The target audience for this work is restricted to high-end specialists in otology, physiology, physics and mathematics and that is the reason why it is so hard to make it more palatable for a wider audience. We hope, however, that those specialist will appreciate our work and will find inspiration for new research concerning these two new organs we described.

Reviewer 3 Report

The authors have improved the work, and I agree with the changes made and the improvements made. Congratulations on the idea and on the results

Author Response

The authors have improved the work, and I agree with the changes made and the improvements made. Congratulations on the idea and on the results

R: We thank you very much for the positive evaluation and we hope our future work concerning this subject will live up to expectations. Our colleagues in this field could beneficiate from our results to take research one step further into the field of histology and imagery.

Author Response File: Author Response.docx