Assessing the Quality of Skull Base Operative Videos in the Neurosurgical Literature: Development of a Neurosurgery-Specific Grading Scale

Background and Objectives: Variability in the quality of operative videos presents a challenge. Several surgical subspecialties have developed scoring systems to address this issue and measure the quality of operative videos in their respective disciplines. The purpose of this project was to evaluate the quality of skull base operative videos in the neurosurgical literature and introduce a novel, neurosurgery-specific grading system—the Neurosurgery-Video Quality Scale (N-VQS)—that better discriminates educational value. Methods: A cross-sectional analysis of 394 skull base operative videos published across four neurosurgical journals was performed. Videos were scored using established instruments (LAP-VEGaS, modified DISCERN, GQS, JAMA Benchmark Criteria) and the newly developed 14-item, 28-point N-VQS. Results: 394 results were included for analysis. Most videos demonstrated high baseline quality across existing grading systems, but these tools showed limited discriminatory power. The N-VQS demonstrated significant correlation with citation frequency (p = 0.049), unlike other scales. Operative Neurosurgery had the highest mean N-VQS scores, while World Neurosurgery publications accrued the highest citation counts. Conclusion: Skull base operative videos are generally high quality, but meaningful variability exists in educational components—particularly discussion of complications and supporting literature. The N-VQS offers a neurosurgery-specific, integrative framework that better correlates with academic impact and may improve standardization of operative video assessment.