Reviewer’s report
Title: Bilateral vocal cord paralysis after endoscopic placement of fully covered self-expandable metal
stent for palliative treatment of malignant proximal esophageal obstruction: two case reports
Version: 0 Date: 04 Apr 2020
Reviewer: Rizwan Ahamed
Reviewer's report:
After reading the article in detail, what strikes immediately unfortunately, is the poor quality of the
English language used in the manuscript including grammatical errors even in the abstract. Kindly
correct these so that the scientific aspects can be assessed accurately. In addition to this, I have a couple
of queries regarding the study.
1. When it is mentioned that the vocal cords were paralysed in adduction, are the authors trying to say
"paramedian position"? If not, does being in adduction help in localizing the involved nerve to be the
posterior  branch  of  the  recurrent  laryngeal  nerve?  A  little  more  discussion  on  the  applied
Neuroanatomy in the discussion part could make the manuscript much moire impressive.
2. The second case is very interesting. It was mentioned that the obstruction was at 23 cms. So, that
certainly gives enough room from the proximal end of compression to the posterior part of the larynx
unless it is being implied that the esophageal SEMS has somehow migrated proximally which i agree is
very rare. You have mentioned that the tracheal stent was in place but was it confirmed that the
esophageal  SEMS  was  also  in  the  initial  position.  Are  the  authors  also  trying  to  say  that  the
compression of the nerve could be due to the tracheal stent too? Please clarify the above
3. The authors'  second hypothesis involving sever reflux as mechanism seems a little too far fetched
for such a serious acute condition especially considering the GE junction was intact. This can be
omitted I think.
4. I am unable to understand the use of a particular terminology; "superficial polypnea". Please explain.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
I declare that I have no competing interests.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: Bilateral vocal cord paralysis after endoscopic placement of fully covered self-expandable metal
stent for palliative treatment of malignant proximal esophageal obstruction: two case reports
Version: 0 Date: 04 Apr 2020
Reviewer: Rizwan Ahamed
Reviewer's report:
After reading the article in detail, what strikes immediately unfortunately, is the poor quality of the
English language used in the manuscript including grammatical errors even in the abstract. Kindly
correct these so that the scientific aspects can be assessed accurately. In addition to this, I have a couple
of queries regarding the study.
1. When it is mentioned that the vocal cords were paralysed in adduction, are the authors trying to say
"paramedian position"? If not, does being in adduction help in localizing the involved nerve to be the
posterior  branch  of  the  recurrent  laryngeal  nerve?  A  little  more  discussion  on  the  applied
Neuroanatomy in the discussion part could make the manuscript much moire impressive.
2. The second case is very interesting. It was mentioned that the obstruction was at 23 cms. So, that
certainly gives enough room from the proximal end of compression to the posterior part of the larynx
unless it is being implied that the esophageal SEMS has somehow migrated proximally which i agree is
very rare. You have mentioned that the tracheal stent was in place but was it confirmed that the
esophageal  SEMS  was  also  in  the  initial  position.  Are  the  authors  also  trying  to  say  that  the
compression of the nerve could be due to the tracheal stent too? Please clarify the above
3. The authors'  second hypothesis involving sever reflux as mechanism seems a little too far fetched
for such a serious acute condition especially considering the GE junction was intact. This can be
omitted I think.
4. I am unable to understand the use of a particular terminology; "superficial polypnea". Please explain.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
I declare that I have no competing interests.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: Bilateral vocal cord paralysis after endoscopic placement of fully covered self-expandable metal
stent for palliative treatment of malignant proximal esophageal obstruction: two case reports
Version: 0 Date: 04 Apr 2020
Reviewer: Rizwan Ahamed
Reviewer's report:
After reading the article in detail, what strikes immediately unfortunately, is the poor quality of the
English language used in the manuscript including grammatical errors even in the abstract. Kindly
correct these so that the scientific aspects can be assessed accurately. In addition to this, I have a couple
of queries regarding the study.
1. When it is mentioned that the vocal cords were paralysed in adduction, are the authors trying to say
"paramedian position"? If not, does being in adduction help in localizing the involved nerve to be the
posterior  branch  of  the  recurrent  laryngeal  nerve?  A  little  more  discussion  on  the  applied
Neuroanatomy in the discussion part could make the manuscript much moire impressive.
2. The second case is very interesting. It was mentioned that the obstruction was at 23 cms. So, that
certainly gives enough room from the proximal end of compression to the posterior part of the larynx
unless it is being implied that the esophageal SEMS has somehow migrated proximally which i agree is
very rare. You have mentioned that the tracheal stent was in place but was it confirmed that the
esophageal  SEMS  was  also  in  the  initial  position.  Are  the  authors  also  trying  to  say  that  the
compression of the nerve could be due to the tracheal stent too? Please clarify the above
3. The authors'  second hypothesis involving sever reflux as mechanism seems a little too far fetched
for such a serious acute condition especially considering the GE junction was intact. This can be
omitted I think.
4. I am unable to understand the use of a particular terminology; "superficial polypnea". Please explain.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
I declare that I have no competing interests.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
assistant