What People Say About Cleft Lip and/or Palate on YouTube: A Thematic and Sentiment Analysis of User Comments.

ObjectiveTo analyze YouTube comments related to cleft lip and/or palate (CL/P) using an infodemiology approach, and to identify prominent themes, emotional patterns, and opportunity/risk areas within the online information ecosystem.DesignA large-scale, mixed-methods cultural infodemiology study. Manual thematic analysis findings were integrated with structural topic modeling (STM) outputs and lexicon-based sentiment analysis (AFINN, NRC) through data triangulation.SettingPublicly available CL/P-related YouTube videos and user comments.Patients, ParticipantsNo patients were recruited; only publicly available comments were analyzed.InterventionsNot applicable.Main Outcome MeasuresThemes derived from STM and manual coding; frequencies of NRC emotion categories; AFINN sentiment scores; word-frequency/word-cloud findings.ResultsA total of 10 550 videos and 23 922 comments were analyzed. In sentiment analysis, positive, joy, and trust categories were predominant, while fear was more prominent among negative emotions. According to AFINN, the overall mean sentiment score across the study period was 1.158, indicating a generally positive trend. Analyses identified 10 main themes and 33 subthemes; prominent themes included psychosocial burden and identity, stigma and bullying, parenting/caregiving burden, a multi-stage treatment process, functional difficulties (speech-feeding-hearing), information seeking, access/cost issues, and misinformation/myth-based explanations.ConclusionsYouTube comments constitute an ecosystem that is both supportive and risk-prone in the context of CL/P. The development of brief, evidence-based video series, standardized "myth-fact" content, clear signposting to trusted resources, and early referral mechanisms for severe psychological distress signals is recommended. In addition, strengthening the visibility of such content through engagement-promoting campaigns may be effective in increasing public awareness.