Pattern of Internal Neck Injuries in Strangulation Deaths With special reference to Laryngeal Fractures
DOI:
https://doi.org/10.48165/Keywords:
Strangulation, Laryngeal fractures, Hyoid and thyroid cartilageAbstract
One of the important finding in strangulation death is injury to laryngeal appendages. A cross sectional study was done to know the incidence of injury to laryngeal cartilages in strangulation deaths autopsied at our department from year 2010 to 2012. A total of 31 cases studied in which ligature strangulation accounted for 18 cases (12 male, 06 female) and manual strangulation 13 cases (7 male and 6 female). Fractures of the hyoid and/or thyroid cartilage were present in 23 cases. Out of 23 cases, hyoid bone fractures noted in 9 cases (23%) and thyroid cartilage fractures found in 17 cases (54%). In ligature strangulation cases hyoid bone fracture present in 5 cases (28%) and thyroid cartilage fracture present in 9 cases (50%). In manual strangulation cases hyoid bone fracture noted in 4 cases (31%) and thyroid cartilage fracture were seen in 8 cases (62%). Cricoid cartilage fracture was not found in our study. Among external features sub-conjunctival hemorrhage was seen in 19 cases and nasal bleeding in 10 cases. Hemorrhage in strap muscles seen in all cases. Thyroid cartilage fracture is more common than hyoid bone fracture in both Ligature and Manual strangulation deaths.
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References
Gonzales TA. Manual strangulation. Arch Pathol 15: 55-65, 1933 2. Kelly M. Trauma to the neck and larynx -Review. CRNA. 1997; 8(1):22-30.
Missliwetz J, Vycudilik W. Homicide by strangling or dumping with postmortem injuries after heroin poisoning? Am. J Forensic Med Pathol. 1997; 18(2):211-4.
Denic N, Huyer DW, Sinal SH, Lantz PE, Smith CR, Silver MM. Cockroach: the omnivorous scavenger. Potential misinterpretation of post-mortem injuries. Am. J Forensic Med Pathol. 1997; 18(2):177-80.
Samarasekera A, Cooke C. The pathology of hanging deaths in Western Australia. Pathology 1996; 28(4):334-8.
Ortmann C, Fechner G. Unusual findings in death by hanging-- reconstruction of capacity for action. Archive fur Kriminologie 1996; 197(3-4):104-10.
Howell MA, Guly HR. Near hanging presenting to an accident and emergency department. Journal of Accident & Emergency Medicine 1996; 13(2):135-6.
Maxeiner H. “Hidden” laryngeal injuries in homicidal strangulation: How to detect and interpret these findings. J Forensic Sci. 1998; 43 (4): 784-791.
Hood I, Ryan D, and Spitz WU. Resuscitation and petechiae. Am. J Forensic Med Pathol. 1998; 19 (1): 35-37
Rao VJ and Wetli CV. The forensic significance of conjunctival petechiae. Am. J Forensic Med Pathol. 1998; 9 (1): 32-34
Ely SF, Hirsch CS. Asphyxial deaths and petechiae: a review. J Forensic Sci. 2000; 45(6): 1274-7.
Pollanen MS. A triad of laryngeal hemorrhages in strangulation: a report of eight cases. J Forensic Sci 2000; 45(3); 614–618.
Pollanen MS. Bulger B. Chiasson DA. The location of hyoid fractures in strangulation revealed by xeroradiography. J Forensic Sci. 1995; 40(2):303-5.
Khokhlov VD. The mechanisms of the formation of injuries to the hyoid bone and laryngeal and tracheal cartilages in compression of the neck. Sudebno-Meditsinskaia Ekspertiza. 1996; 39(3):13-6
Patel F. Strangulation injuries in children. Journal of Trauma. 1996; 41(1):171
Hanigan WC. Aldag J. Sabo RA. Rose J. Aaland M. Strangulation injuries in children. Part 2. Cerebrovascular hemodynamics. Journal of Trauma. 1996; 40(1):73-7
Sabo RA. Hanigan WC. Flessner K. Rose J. Aaland M. Strangulation injuries in children. Part 1. Clinical analysis [see comments]. Journal of Trauma. 1996; 40(1):68- 72.
Pollanen MS. Chiasson DA. Fracture of the hyoid bone in strangulation: comparison of fractured and unfractured hyoids from victims of strangulation. J Forensic Sci. 1996; 41(1):110-3.
Saukko P, Knights B. Fatal pressure on the neck. In: Knights forensic pathology. 3rd ed. London: Arnol Publication; 2004. p.377. 20. Parikh CK. Violent asphyxial deaths. In: Parikh’s textbook of Medical Jurisprudence Forensic Medicine and Toxicology. 6th ed. Delhi: CBS Publishers and Distributors; 2008 p.3.40-3.73.
Polson CJ, Gee DJ, Knight B. Hanging and strangulation. In: The essential of Forensic Medicine, 4th ed. Pergamon Press; 1985. P.375 and 405
DiMaio VJ. Homicidal asphyxia. Am J Forensic Med Pathol. 2000; 21(1):1-4.