How do people perceive orthognathic surgery on YouTube? A sentiment and thematic analysis of 111,953 comments

Patients in the orthognathic surgery process frequently turn to social media to obtain information and share their experiences. Accordingly, the present study analyzed YouTube comments to evaluate patient satisfaction, emotional tendencies, and social interactions, aiming to draw implications for improving communication and psychological support strategies.

A total of 250,582 comments from 8044 YouTube videos on orthognathic surgery were collected using Mozdeh (University of Wolverhampton, Wolverhampton, UK) and R software (version 4.2.2, Posit, PBC, Boston, Mass). After preprocessing, 111,953 comments remained. Sentiment analysis (AFFIN/NRC lexicons), structural topic modeling, and manual thematic analysis (10% sample) were performed. Gender-based discourse differences were examined using Chi-square tests with Benjamini-Hochberg correction.

Ten main themes were identified through structural topic modeling and thematic analyses. Positive emotions were mostly expressed, though fear and negativity were also observed. Esthetic and emotional expressions were used more often by women, whereas cost-related terms were used more often by men. Thematic qualitative analyses revealed that YouTube videos and comments were perceived by patients as a source of psychological support, whereas certain misleading content was also found to have the potential to misguide patients during the treatment process.

This study has transcended the limited scope of traditional surveys, which are confined to specific time periods and small sample sizes, by making it possible to access patient experiences shared on the YouTube platform without temporal or spatial constraints. The analyses revealed prevalent misconceptions on social media and assessed patients' expectations, concerns, and psychological states. The findings serve as a practical guide for healthcare professionals in developing patient-centered communication and care strategies.