Case 05 2026: Partial avulsion of the nasal tip

Keywords: Trauma, Nasal tip, Avulsion, rhinoplasty Authors: Nicolai Lassen Frid, MD, Johan Hindkjær Therchilsen, MD, Jakob Gerlach Christensen, MD Institution: Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark Abstract Traumatic partial avulsion of the nasal tip is a rare condition that can present both functional and aesthetic challenges. This case reports a 58-year-old woman with a partial nasal tip avulsion after a fall onto a metal crate. Examination revealed injury to the lower lateral cartilages with loose cartilaginous fragments. Surgical repair focused on restoration of the structural tip support, using end-to-end sutures for approximation of the cartilage and interdomal suturing. This case focuses on rhinoplasty-based principles in acute management of nasal trauma to preserve projection, symmetry, and long-term stability of the nose. Patient medical history A 58-year-old woman presented to the emergency department with a traumatic partial avulsion of the nasal tip sustained after slipping on ice and striking her face against a metal crate. The patient reported neck soreness but exhibited no signs of concussion and no other facial injuries or neck injuries. She had no prior history of nasal trauma. Her medical history included well-controlled hypertension and chronic back pain. Before and After Patient examination Examination of the external nose revealed a large laceration involving the nasal tip, with partial avulsion on the right side. The lower lateral cartilages were injured, with transection of the right lateral crus, a loose fragment of the right intermediate crus, and bilateral fractures of the medial crura with loose cartilaginous fragments. The skin was intact over the columellar and the left alar surface. The wound edges were well defined and with no tissue loss. Sensation was absent in the lacerated tip, but with preserved capillary refill. Anterior rhinoscopy showed a midline septum without h