Diagnosis of drowning using post-mortem computed tomography based on the volume and density of fluid accumulation in the maxillary and sphenoid sinuses

Exact volumetric determination of fluid in the paranasal sinuses after drowning

“…Males has overall larger sinuses (except for the right sphenoid sinuses), but the females had overall the greatest total amount of fluid in the sinuses. As in other studies [9,10,12], we found significantly more fluid accumulation in the paranasal sinuses (maxillary, sphenoid and frontal) in the drowning cases than in the non-drowning cases. There was no clear pattern in the overall distribution of present fluid based on sex or sinus volume.…”

“…Christe et al [9] reported that all their examined drowning cases had significantly more fluid accumulation in the maxillary and sphenoid sinuses than their non-drowning cases. Kawasumi et al [10] used CT-scan images to measure the amount of fluid in the paranasal sinuses as well as the density of the fluid, based on Hounsfield Units (HU), and they also reported significant differences between the drowning and the non-drowning group. However, they did not take autopsy findings or aspects of wet and dry drowning into consideration, and they also did not compare the volume of fluid in the paranasal sinuses against the paranasal volume as such.…”

Post-mortem evaluation of drowning with whole body CT

“…However, it should be noted that fluid in the paranasal sinuses or within the trachea can also be found in other causes of death such as cardiovascular failure, burning victims and poisoning [7]. Opacities in the lungs can also be diagnosed for example in case of myocardial infarction or congestive heart failure [13].…”

Role of virtopsy in the post-mortem diagnosis of drowning

“…In order to overcome the limits of the conventional autopsy in the diagnosis of drowning, post-mortem radiological imaging techniques are taking a prominent role. Computed tomography (CT) virtual autopsy (virtopsy) represents an effective imaging modality in the diagnosis of drowning, even if drowning can not be diagnosed solely through CT [5][6][7][8][9][10]. In drowning victims, inhaled and aspirated fluid enters the paranasal sinuses as it passes through the nasal cavity; hence, as proved by recent reports, the CT finding of fluid accumulation in the maxillary and sphenoidal sinuses is supportive of the diagnosis of drowning [10][11][12].…”