Embryology, normal anatomy, and imaging techniques of the hyoid and larynx with respect to forensic purposes: a review article

Abstract

Experiences with pre- and postmortem imaging in a forensic setting create more and more interest. If autopsy is permitted, forensic pathologists perform careful examination of the neck structures, which plays an important role as this is decisive in the diagnostics of compressive neck injury. Primary tools are important: forensic pathologists and radiologists are supposed to be aware of the complex anatomy of the neck, especially the laryngeal region, to interprete their findings at autopsy and after imaging. It is of great interest whether CT and MR imaging techniques would be useful in comparing findings of autopsy and document findings if autopsy is refused. In the light of this, the embryology, anatomy and a review of imaging techniques of the neck will be highlighted in this article, with special attention to the value of updated imaging techniques of the larynx for forensic purposes in living people and postmortem.

The development of the human hyoid–larynx complex revisited

“…The textbook view on the development of the hyoid–larynx complex (Fig. B) states that the body of the hyoid bone derives from second and third pharyngeal arch cartilages, contributing to the upper and lower part of the hyoid bone body, respectively . Anatomic variations that match this notion of a dual origin of the body of the hyoid bone have not been reported.…”

“…7,9 The lesser and greater horns are normally united to the quadrilateral shaped hyoid bone body by fibrous tissue or a true joint, which may become ankylosed later in life. 6,7,[9][10][11][12][13][14][15] The lesser horns are also known in literature as cornu minus, epihyal, hypo-hyal, or apohyal, 16,17 and the greater horn as cornu majus.…”

“…(A) Lateral view of a schematic representation of the normal anatomy of the adult neck region including anatomical annotations. (B) The current opinion of the division of the neck region in five pharyngeal arch zones, depicting the origin of each component of the hyoid–larynx complex . (C) Proposed view on the development of the hyoid–larynx complex.…”

“…Ankylosis is a physiological process that progresses with age . Morphological variations of the hyoid bone are closely related to sex, race, body proportions (weight and length), and age . Multiple variations can be found in the same person, and variations can occur either unilaterally or bilaterally, and even absence of the hyoid bone has been reported .…”

Fatal Paradoxical Air Embolism Diagnosed by Postmortem Imaging and Autopsy

“…KEYWORDS: forensic science, paradoxical air embolism, postmortem imaging, patent foramen ovale, central venous catheter removal Postmortem computed tomography (CT) examination is utilized in the field of forensic pathology because it can be used to assess causes of death, injury, and for personal identification (1,2). CT examination before autopsy is able to provide not only information to guide the autopsy, but also significant findings to analyze the cause of death, which may not be possible in autopsy (3,4).…”