“…Anatomical differences among sinus openings could potentially influence the entry of fluid, and therefore, the absence of fluid in the sinuses may not necessarily rule out drowning as a cause of death in bodies found in water. While the ovine model has limitations in that the sinus sizes differ somewhat to that of humans [ 39 ], they provide a unique and valuable opportunity to investigate the mechanistic insights into sinus pathophysiology [ 41 , 42 ]. The rotation of heads during examination was also noted to cause a reduction in volume and it may be further hypothesized that the volume differences between sinuses in our study may be due to their position during submersion.…”
Section: Discussionmentioning
confidence: 99%
“…1 B) [ 38 ]. Despite the absence of the sphenoid sinus in quadrupeds, the ovine nasal cavities are still regarded as valuable and suitable alternatives for endoscopic sinus surgical training [ 39 – 41 ]. Fig.…”
Fluid-filled paranasal sinuses are suggested to be a valuable tool to distinguish between drowning and non-drowning postmortem, yet the mechanisms governing fluid entry remains unknown. We investigate if fluid-filled paranasal sinuses are caused by a passive influx from submersion or an active aspiration mechanism during drowning. The ovine nasal cavity and maxillary sinuses are remarkably similar anatomically to humans, and have been used for endoscopic surgical training in recent decades. We submerged 15 decapitated ovine heads from agricultural waste at a depth of 2 m in flowing water for 1, 8, and 24 h and 7 days. Paranasal sinuses were CT imaged and compared pre- and post-submersion to non-submerged controls. Furthermore, we examined the paranasal sinuses of a single homicide case of a non-drowned submerged subject. Results demonstrate that fluid passively enters the maxillary sinus postmortem in the non-drowned ovine heads following 1 h of submersion. Fluid volume was independent of submersion time and influenced by time out of water as well as handling, since volume was reduced between consecutive CT scans. In contrast to our hypothesis, the filling of the paranasal sinuses is due to passive influx of fluid from submersion rather than an active aspiration during drowning. The observation that paranasal sinuses were fluid-filled in a single medico-legal case of postmortem submersion supports the finding of passive influx. Consequently, careful interpretation of fluid-filled paranasal sinuses is required when bodies are found in water, as the finding cannot distinguish between postmortem submersion and drowning.
“…Anatomical differences among sinus openings could potentially influence the entry of fluid, and therefore, the absence of fluid in the sinuses may not necessarily rule out drowning as a cause of death in bodies found in water. While the ovine model has limitations in that the sinus sizes differ somewhat to that of humans [ 39 ], they provide a unique and valuable opportunity to investigate the mechanistic insights into sinus pathophysiology [ 41 , 42 ]. The rotation of heads during examination was also noted to cause a reduction in volume and it may be further hypothesized that the volume differences between sinuses in our study may be due to their position during submersion.…”
Section: Discussionmentioning
confidence: 99%
“…1 B) [ 38 ]. Despite the absence of the sphenoid sinus in quadrupeds, the ovine nasal cavities are still regarded as valuable and suitable alternatives for endoscopic sinus surgical training [ 39 – 41 ]. Fig.…”
Fluid-filled paranasal sinuses are suggested to be a valuable tool to distinguish between drowning and non-drowning postmortem, yet the mechanisms governing fluid entry remains unknown. We investigate if fluid-filled paranasal sinuses are caused by a passive influx from submersion or an active aspiration mechanism during drowning. The ovine nasal cavity and maxillary sinuses are remarkably similar anatomically to humans, and have been used for endoscopic surgical training in recent decades. We submerged 15 decapitated ovine heads from agricultural waste at a depth of 2 m in flowing water for 1, 8, and 24 h and 7 days. Paranasal sinuses were CT imaged and compared pre- and post-submersion to non-submerged controls. Furthermore, we examined the paranasal sinuses of a single homicide case of a non-drowned submerged subject. Results demonstrate that fluid passively enters the maxillary sinus postmortem in the non-drowned ovine heads following 1 h of submersion. Fluid volume was independent of submersion time and influenced by time out of water as well as handling, since volume was reduced between consecutive CT scans. In contrast to our hypothesis, the filling of the paranasal sinuses is due to passive influx of fluid from submersion rather than an active aspiration during drowning. The observation that paranasal sinuses were fluid-filled in a single medico-legal case of postmortem submersion supports the finding of passive influx. Consequently, careful interpretation of fluid-filled paranasal sinuses is required when bodies are found in water, as the finding cannot distinguish between postmortem submersion and drowning.
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