Assessment of the quality of endoscopic tympanoplasty and endoscopic myringoplasty videos on YouTube

YouTube has become a widely used platform for surgical education, especially in otolaryngology. Despite its popularity, the educational quality of available content remains largely unregulated. This study aimed to evaluate the quality of endoscopic type 1 tympanoplasty and myringoplasty videos on YouTube using two validated assessment tools: the modified IVORY and the LAP-VEGaS systems. A systematic search was conducted on YouTube in November 2024 using specific keywords. A total of 105 English-language videos demonstrating endoscopic type 1 tympanoplasty or myringoplasty were included based on predefined inclusion criteria (view count ≥ 1.000, duration 1–60 min, and accessible engagement metrics). The IVORY scoring system was modified to better fit the procedure and the YouTube platform. Two independent otolaryngologists evaluated all videos using the modified IVORY and standard LAP-VEGaS scoring systems. Inter-rater reliability was assessed with Cohen’s Kappa and Intraclass Correlation Coefficients (ICC). Relationships between video characteristics and educational quality were analyzed using Spearman correlation and linear regression. The mean LAP-VEGaS score was 5.9 ± 2.8, with 63.8% of videos rated as low quality (score < 7). The mean IVORY score was 16.4 ± 3.8, and 95.2% of videos received an F grade academically. A strong positive correlation was observed between LAP-VEGaS scores and video likes (r = 0.474, p < 0.001), view rate (r = 0.411, p < 0.001), and views (r = 0.299, p = 0.002), while a negative correlation was found with video upload age (r = − 0.435, p < 0.001). Similarly, IVORY scores were positively correlated with likes (r = 0.349, p < 0.001) and view rate (r = 0.258, p = 0.008), and negatively correlated with upload age (r = − 0.346, p < 0.001). Linear regression showed that the number of likes (β = 0.465, p = 0.002) and upload age (β = − 0.339, p < 0.001) significantly predicted LAP-VEGaS scores. For IVORY scores, upload age was a significant negative predictor (β = − 0.001, p < 0.001). Inter-rater reliability was excellent for both scoring systems, with ICC values of 0.896 for LAP-VEGaS and 0.910 for IVORY. Most YouTube videos on endoscopic type 1 tympanoplasty and myringoplasty lack high educational quality. Implementing structured guidelines and specialty-specific video evaluation tools is crucial to enhance the educational value of online surgical content. Promoting adherence to instructional design principles may improve the effectiveness of freely available video resources.