Abstract
Background: The subjective nature of rhinoplasty makes it difficult to objectively evaluate nasal tip aesthetics, which in turn makes it difficult to reproduce and compare results. In response to this need, a standardized scoring system that accounts for key morphological and aesthetic factors was developed: the INTAS (Integrated Nasal Tip Aesthetic Score). The purpose of this research was to assess the trustworthiness and validity of the Turkish version of the INTAS.
Methods: To validate the methods, 250 patients from different tertiary referral hospitals who underwent primary rhinoplasty were enrolled. Multiple experienced surgeons independently assessed standardized pre- and postoperative images using the Turkish version of INTAS. We evaluated internal consistency using Cronbach's alpha. We assessed interobserver agreement using the kappa statistic and the intraclass correlation coefficient (ICC). We used the Kolmogorov-Smirnov test to assess the distributions of variables and conducted nonparametric tests as needed. For this study, we used Kruskal-Wallis and Dunn's post hoc tests to compare the groups. A p-value less than 0.05 was considered statistically significant.
Results: The analysis included 250 patients. Objective Nasal Tip Definition Scores on the Turkish INTAS had a Cronbach's alpha of 0.768, and the overall eight-item structure of the test had a score of 0.710. These results indicate robust internal consistency. Moderate yet substantial links among the domains were demonstrated by inter-item correlations ranging from 0.361 to 0.495, which maintained conceptual independence. In addition, corrected item-total correlations for each of the four domains ranged from 0.509 to 0.608 (well above the acceptable threshold of 0.30), indicating robust reliability. This level of reproducibility is supported by the intraclass correlation coefficient (ICC) results. The construct validity of INTAS was supported by its ability to differentiate across groups of aesthetic outcomes (p < 0.001). The statistical significance of the differences between the specified subgroups was confirmed by post hoc analysis.
Conclusion: The Turkish version of the Integrated Nasal Tip Aesthetic Score (INTAS) is a viable, accurate, and reproducible tool for objectively evaluating nasal tip aesthetics. Its uniform format may aid clinical decision-making and comparative research in rhinoplasty by enabling consistent evaluation across surgeons.
Authors
Erdi Özdemir, Nuray Bayar Muluk, Gürcan Sünnetçi, Cengiz Bal, Mustafa Yazir, Serkan Barışkan, Yunus Emre Topan, Furkan Kaya, Ali Değirmenci, Ahmet Altuntaş, Mesut Yeşilova, Sevilay Aynaci, Cemal Cingi
Keywords
Integrated Nasal Tip Aesthetic Score (INTAS), Turkish version, Rhinoplasty, Nasal tip, Aesthetics, Validation, Scoring system
Publication Information
- Publication Date
- June 3, 2026
- Submission Date
- May 26, 2026
- Volume
- 1
- Issue
- 2026-1
- Year
- 2026
- Pages
- 1-9
- Language
- English
- Status
- Published
- Views
- 18
- Downloads
- 0
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