Evaluation of the Quality of Tympanoplasty Videos on YouTube Using the Ivory Grading System

Abstract

Purpose

YouTube has become a key platform for sharing information on surgical procedures. However, the absence of peer review raises concerns about the educational quality and reliability of its content. The IVORY grading system was developed to address this gap in otorhinolaryngology. This study aims to evaluate the educational quality of tympanoplasty videos on YouTube using the IVORY system and identify deficiencies.

Methods

Ninety-four tympanoplasty videos were analyzed based on inclusion and exclusion criteria. Video metrics such as duration, views, and likes were recorded, and videos were scored on a 0–2 scale using the IVORY system. Total scores were categorized from A to F. Statistical analyses examined the relationships between IVORY scores and video characteristics.

Results

The median IVORY score of the videos was 21.0 (IQR: 17.0–24.0). Only 4.3% of the videos (A and B categories) were of high educational quality, while 68.1% were classified as low quality (F category). A weak but significant correlation was found between IVORY scores and metrics such as views (p = 0.008, r = 0.271) and likes (p = 0.005, r = 0.288). Video duration showed a significant negative correlation with IVORY scores (beta = −0.05, p = 0.012). Geographic differences significantly affected video quality (p < 0.05).

Conclusion

This study highlights YouTube's potential as a resource for surgical education while also revealing significant shortcomings in video quality. The broader adoption of guidelines like the IVORY system and the encouragement of producing content aligned with these standards would be an important step toward improving the quality of surgical educational materials.

Level of Evidence

NA.