A Naso-Orbito-Ethmoid (NOE) Fracture Associated with Bilateral Anterior and Posterior Frontal Sinus Wall Fractures Caused by a Horse Kick—Case Report and Short Literature Review
Round 1
Reviewer 1 Report
It is a good description of a direct trauma caused by horse kick. It was important to do the early treatment, because there were no brain injury and no cerebrospinal fistula. It could be discusses to obliterate the sinus with adipose tissue because it can dissolve. The orbital margin fracture with minimal dislocation could be accessed by a tranconjunctival incision as you already mentioned in Discussion. Discussion could be shorter without repeating all the steps of the operation procedure.
Author Response
To reviewer nr 1.
Thank you for your kind revision of the manuscript and for your kind advice,
We modified the manuscript according to your remarks as follows:
Point 1. It could be discusses to obliterate the sinus with adipose tissue because it can dissolve
Response 1: We added in the discussion section comments regarding the dissolving of the abdominal fat graft in time as you suggested (line 274-276). Marked in purple color.
Point 2. Discussion could be shorter without repeating all the steps of the operation procedure.
Response 2: We reduced the legth of the discussion section as you suggested.
Thank you very much for your time,
Regards,
Asist.Univ.Dr.Dr.Țenț Paul Andrei M.D. D.M.D PhD
Department of Oral and Maxillofacial Surgery
University of Oradea, Romania
Reviewer 2 Report
Thank you for giving me opportunity to review this Case report article.
I here carefully reviewed the article and found it no merits of publication.
The case report seems to be interesting, but this is not a rare case and the treatment is the ordinary work-up without any scientific impacts. Furthermore, there are no postoperative x-rays nor facial photos. Also, the authors used a wrong terminology of "hypertelorism", which should be inappropriate for NOE fracture patient.
I am sorry but I can't support this Case report for publication, and should be re-submitted for a domestic scientific journal.
Author Response
To reviewer nr 2.
Thank you for your kind revision of the manuscript and for your kind advice,
We modified the manuscript according to your remarks as follows:
Point 1. Moderate English Language revision
Response 1. In the first place we made the English language revision of it with the help of an authorized english translator specializing in medical manuscripts. I hope that you will find it appropriate this time.
Point 2. The authors used a wrong terminology of "hypertelorism", which should be inappropriate for NOE fracture patient.
Response 2: We have removed the use of the term hypertelorism as you have recommended, using the more appropriate term of telecantus in this case.
Point 3. Furthermore, there are no postoperative x-rays nor facial photos.
Response 3: Case report: - we added clinical photos of the patient 9 moths after surgery and also ct-scan images as you suggested (Fig.9 and Fig. 10) .
Point 4. this is not a rare
Response 4 : we find it rare both due to the etiology and to the clinical characters related to the kinetic energy of the impact, the patient not showing intracranial lesions despite the major fracture displacement at FSNOE level.
Thank you very much for your time,
Regards,
Asist.Univ.Dr.Dr.Țenț Paul Andrei M.D. D.M.D PhD
Department of Oral and Maxillofacial Surgery
University of Oradea, Romania
Reviewer 3 Report
Introduction
The anatomical aspects of NOE and sinus wall fractures are sufficiently explained but the clinical picture and above all the diagnostic approach is poorly argued and must be improved.
Clinical case
The clinical case il well described with a sufficient iconography both in the pre, intra and post-operative phase of treatment.
However the last images are related to 7th post-operative day; it would be of interest a control after 8-10 months or more, in order to demostrate the complete recovery occured to the patient.
Discussion
The discussion section is too long and dwells on irrilevant descriptions, such as the different type of incisions for the approach of NOE, that are not of interest for the reader.
More considerations must be inserted about clinical aspects and diagnostic procedure.
Conclusions
Conclusion section is synthetic but effective, however is related only to the importance of a tempestive surgical correction; could be of interest some considerations about the diagnostic procedures and the multidisciplinary approach.
Author Response
To reviewer nr 3.
Thank you for your kind revision of the manuscript and for your kind advice,
We modified the manuscript according to your remarks as follows:
Point 1. Moderate English Language revision
Response 1: In the first place we made the English language revision of it with the help of an authorized english translator specializing in medical manuscripts. I hope that you will find it appropriate this time.
Point 2. Introduction: the diagnostic approach is poorly argued and must be improved.
Response 2: - with completed the introduction with aspects regarding the diagnosis of NOE fractures (line 42-47).
Point 3. it would be of interest a control after 8-10 months or more, in order to demostrate the complete recovery occured to the patient.
Response 3 Case report: - we added clinical photos of the patient 9 moths after surgery and also ct-scan images as you suggested (Fig.9 and Fig. 10).
Point 4. he discussion section is too long and dwells on irrilevant descriptions, such as the different type of incisions for the approach of NOE, that are not of interest for the reader.More considerations must be inserted about clinical aspects and diagnostic procedure.
Response 4 Discussions – we added clinical examination, tests and imagistic aspects important for the Noe and Frontal sinus fractures complete diagnosis (line 188-199). Also we have reduced the text in this section according to your kind advice.
Point 5. Conclusion section is synthetic but effective, however is related only to the importance of a tempestive surgical correction; could be of interest some considerations about the diagnostic procedures and the multidisciplinary approach.
Response 5 Conclusions – we completed this section according to your advice (line 306-309).
We mention that all the revisions in text are marked in red fore reviewer nr. 3 and also highlighted in comments section on the right.
Thank you very much for your time,
Regards,
Asist.Univ.Dr.Dr.Țenț Paul Andrei M.D. D.M.D PhD
Department of Oral and Maxillofacial Surgery
University of Oradea, Romania
Round 2
Reviewer 2 Report
Thank you for giving me this opportunity to re-review the revised manuscript.
I here carefully reviewed the revised set of the article and found it merits of publication. Congratulations on the authors.
