Tonsillectomy and social media: An investigative analysis of educational tonsillectomy content on TikTok

The use of social media platforms has aided in spreading information more rapidly than ever before. More recently, emerging as the fastest growing social media platform and one of the fastest to gain popularity is TikTok. As of November 15, 2021, TikTok is the most downloaded free application on both Apple and Google Play Store. TikTok is a video‐sharing platform that creators use to post about endless topics through various forms such as dances, songs, or dialogs. Anyone can become a creator on TikTok, and this provides the opportunity for people to both views and add videos about trending topics. The app generates premade templates and audio for users to use, making it easy for anyone to create content. For viewers, the videos are intentionally designed to be short, allowing users to watch more content in a reduced amount of time. Furthermore, TikTok trends seem to be the most viral videos as it showcases current trends, icons, and lifestyles. Aside from entertainment, educational health content and personal experiences of different health conditions are also frequently posted. Since most of the viewership on TikTok videos is randomly selected rather than only followers/friends, like most other popular social media platforms, information can spread faster than ever before. For the medical community, this creates a platform for providers and patients to share information anywhere from patient experiences to medical conditions and their treatment. Studies have already been conducted on this for topics, such as concussions, cosmetic procedures, and acne. Given the popularity and rapid ability of TikTok to circulate information, we were interested in analyzing otolaryngology content. Prior studies have been conducted analyzing otolaryngology content on other social media platforms, such as Youtube and Twitter; however, our study is the first to explore and characterize otolaryngology content and specifically tonsillectomy content on TikTok. Tonsillectomy is the surgical removal of the tonsils to treat commonly recurrent tonsillitis and hypertrophy of the tonsils causing respiratory problems, and less commonly for peritonsillar abscess, biopsy, and as an access to other structures. Studies indicate that tonsillectomy in patients with recurrent tonsilitis provides improved quality of life and decreased upper respiratory tract infections and sinus infections. The most common complications of tonsillectomy include postoperative hemorrhage and infections, which may require immediate surgical interventions. On the basis of the most recent published data, tonsillectomies are among the most common surgical procedures in the United States, with 289,000 ambulatory procedures done annually in children less than 15 years of age. With tonsillectomy being the most commonly performed otolaryngology procedure, analyzing this topic will provide a plethora of informational content. The purpose of this study is to analyze content related to otolaryngology, specifically in relation to tonsillectomy, found on TikTok. We aim to recommend methods to improve patient education, patient–provider interactions, and shared decision‐making.


| INTRODUCTION
The use of social media platforms has aided in spreading information more rapidly than ever before. More recently, emerging as the fastest growing social media platform and one of the fastest to gain popularity is TikTok. 1 As of November 15, 2021, TikTok is the most downloaded free application on both Apple and Google Play Store.
TikTok is a video-sharing platform that creators use to post about endless topics through various forms such as dances, songs, or dialogs. Anyone can become a creator on TikTok, and this provides the opportunity for people to both views and add videos about trending topics. The app generates premade templates and audio for users to use, making it easy for anyone to create content. For viewers, the videos are intentionally designed to be short, allowing users to watch more content in a reduced amount of time.
Furthermore, TikTok trends seem to be the most viral videos as it showcases current trends, icons, and lifestyles. Aside from entertainment, educational health content and personal experiences of different health conditions are also frequently posted. 2 Since most of the viewership on TikTok videos is randomly selected rather than only followers/friends, like most other popular social media platforms, information can spread faster than ever before. 1,2 For the medical community, this creates a platform for providers and patients to share information anywhere from patient experiences to medical conditions and their treatment. Studies have already been conducted on this for topics, such as concussions, cosmetic procedures, and acne. [2][3][4] Given the popularity and rapid ability of TikTok to circulate information, we were interested in analyzing otolaryngology content. Prior studies have been conducted analyzing otolaryngology content on other social media platforms, such as Youtube and Twitter; however, our study is the first to explore and characterize otolaryngology content and specifically tonsillectomy content on TikTok. 5 Tonsillectomy is the surgical removal of the tonsils to treat commonly recurrent tonsillitis and hypertrophy of the tonsils causing respiratory problems, and less commonly for peritonsillar abscess, biopsy, and as an access to other structures. 6,7 Studies indicate that tonsillectomy in patients with recurrent tonsilitis provides improved quality of life and decreased upper respiratory tract infections and sinus infections. 7 The most common complications of tonsillectomy include postoperative hemorrhage and infections, which may require immediate surgical interventions. [6][7][8] On the basis of the most recent published data, tonsillectomies are among the most common surgical procedures in the United States, with 289,000 ambulatory procedures done annually in children less than 15 years of age. 8 With tonsillectomy being the most commonly performed otolaryngology procedure, analyzing this topic will provide a plethora of informational content. 7 The purpose of this study is to analyze content related to otolaryngology, specifically in relation to tonsillectomy, found on TikTok. We aim to recommend methods to improve patient education, patient-provider interactions, and shared decision-making. shown to be a reliable instrument to judge the quality of health information. 9 If the average score differed by greater than 3 points, an additional reviewer (Jithin John) was utilized to maintain accurate results.   (1), and a neurologist (1) (Figure 3). When stratified, the DISCERN score was higher for videos created by physicians (DISCERN average 2.57) than for videos created by nonphysicians (DISCERN average 1.65) (p < 0.001) ( Table 1).

| RESULTS
The number of male and female otolaryngologists and nonotolaryngologists videos was also collected and characterized, as shown in (Table 2).

TRANSPARENCY STATEMENT
The lead author (manuscript guarantor) affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.