Preoperative differentiation between benign and malignant parotid gland tumors is challenging. Apparent Diffusion Coefficient (ADC) from Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) and systemic inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have emerged as non-invasive diagnostic tools. To evaluate the diagnostic utility of ADC, NLR, and PLR individually and in combination for distingushing benign from malignant parotid tumors and for differentiating major histopathological subtypes. This retrospective study included 138 patients with histopathologically confirmed parotid tumors. ADC values were obtained from DW-MRI, and NLR and PLR were calculated from preoperative CBC. A decision tree model incorporating age, gender, ADC, PLR, and NLR was developed, and diagnostic performance was assessed using ROC analysis. Complete data was available for for 108 patients. The decision tree achieved an AUC of 0.837 for malignancy prediction, with age and PLR as key predictors. Excluding ADC did not impact model performance (AUC=0.837; p=1.0). While ADC alone did not differentiate malignancy, it was effective for subtype classification: AUC=0.891 for Warthin tumor vs pleomorphic adenoma, and 0.771 for pleomorphic adenoma vs mucoepidermoid carcinoma. Systemic inflammation markers enhance malignancy prediction, whereas ADC contributes meaningfully to histological subtype differentiation.

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.

To carry out an exhaustive bibliometric analysis of the existing literature on endoscopic dacryocystorhinostomy (DCR), with a view to comparing this with the trend in external DCR. A total of 1,230 publications on endoscopic DCR and 1,036 on external DCR were retrieved from the Web of Science databases and analyzed. Data on publication types, indexing categories, journal and publisher contributions, temporal trends, authorship networks, frequently used keywords, and country-level contributions were evaluated. Co-authorship and keyword co-occurrence networks were visualized to identify collaboration patterns and thematic focuses. Citation metrics, including the top 100 most-cited publications, were also assessed. Original articles accounted for over 85% of the publications in both endoscopic and external DCR literature. The research is predominantly concentrated in ophthalmology (44.4%) and otorhinolaryngology (32.1%) for endoscopic DCR, with most publications indexed in the Science Citation Index Expanded (77.3%). The number of endoscopic DCR publications peaked in 2020, while external DCR peaked in 2015. Ali Mohammad Javed emerged as the most prolific author with 78 publications, and the co-authorship network revealed strong interdisciplinary collaborations. India led the publication output for both endoscopic (16.9%) and external (15.7%) DCR, followed by the United States and Turkey. Frequently used keywords such as "dacryocystorhinostomy" and "epiphora" highlighted the primary clinical focus. The bibliometric analysis highlights the increasing trend in publications over the last decade, indicating an escalating interest in minimally invasive methods, with endoscopic DCR being a prominent approach for the management of nasolacrimal duct obstruction. Key contributors, impactful journals, and strong collaborations drive innovation in the field. However, research gaps remain in patient-reported metrics, and contributions from underrepresented regions. Addressing these areas through international and multidisciplinary efforts will advance the field further.