Unusual presentation of blunt laryngeal injury with cricotracheal disruption by attempted hanging: a case report

Borowski, David W; Mehrotra, Pallavi; Tennant, D.; Badawey, Mohamed Reda El; Cameron, Duncan

doi:10.1016/j.amjoto.2003.11.001

Cited by 21 publications

(12 citation statements)

References 16 publications

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“…However, only few reports deal with neck alterations after survived strangulation [15][16][17], and the radiological evaluation is mainly based on CT. According to the literature, MRI has not been used for the assessment of survived strangulation in forensic cases apart from one manual strangulation incident that was reported by Yen et al [12].…”

Section: Discussionmentioning

confidence: 99%

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings

et al. 2007

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Based on only one objective and several subjective signs, the forensic classification of strangulation incidents concerning their life-threatening quality can be problematic. Reflecting that it is almost impossible to detect internal injuries of the neck with the standard forensic external examination, we examined 14 persons who have survived manual and ligature strangulation or forearm choke holds using MRI technique (1.5-T scanner). Two clinical radiologists evaluated the neck findings independently. The danger to life was evaluated based on the "classical" external findings alone and in addition to the radiological data. We observed hemorrhaging in the subcutaneous fatty tissue of the neck in ten cases. Other frequent findings were hemorrhages of the neck and larynx muscles, the lymph nodes, the pharynx, and larynx soft tissues. Based on the classical forensic strangulation findings with MRI, eight of the cases were declared as life-endangering incidents, four of them without the presence of petechial hemorrhage but with further signs of impaired brain function due to hypoxia. The accuracy of future forensic classification of the danger to life will probably be increased when it is based not only on one objective and several subjective signs but also on the evidence of inner neck injuries. However, further prospective studies including larger cohorts are necessary to clarify the value of the inner neck injuries in the forensic classification of surviving strangulation victims.

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Section: Discussionmentioning

confidence: 99%

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings

et al. 2007

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“…MRI and CT may be useful means of investigation in this setting because of their potency to depict both the soft-tissue damage and the osseous trauma. There are only four publications that address the use of CT imaging in survivors of laryngeal trauma after blunt neck trauma in a forensic setting [36][37][38][39]. Stanley and Hanson [36] address the use of CT as an excellent, noninvasive technique to evaluate and verify cartilaginous laryngeal fractures and soft-tissue injury.…”

Section: Imaging Of the Larynx For Forensic Purposes In Living Patientsmentioning

confidence: 97%

“…Oh et al [38] published their Wndings in a case report after strangulation, where CT scan seemed to be useful in diagnosing a displaced cricoid fracture. Borowski et al [39] demonstrated the value of CT to diagnose disruption of the cricotracheal junction and soft-tissue injuries of the great vessels of the neck in an attempted suicide by hanging.…”

Section: Imaging Of the Larynx For Forensic Purposes In Living Patientsmentioning

confidence: 98%

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

Soerdjbalie‐Maikoe

Rijn

2008

Forensic Sci Med Pathol

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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.

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“…Motor vehicle accidents are the most common cause of blunt trauma to the airway, with hanging as a method of attempting suicide increasing in incidence [3, 4]. Laryngeal injuries were observed in 35% to 45% of victims of hanging at autopsy [5]. Because laryngotracheal separation caused by hanging usually results in early death at the scene, the true incidence is unknown [2, 3, 5].…”

Section: Discussionmentioning

confidence: 99%

“…Laryngeal injuries were observed in 35% to 45% of victims of hanging at autopsy [5]. Because laryngotracheal separation caused by hanging usually results in early death at the scene, the true incidence is unknown [2, 3, 5]. …”

Section: Discussionmentioning

confidence: 99%

Complete Laryngotracheal Separation Following Attempted Hanging

Koo

Rha

et al. 2012

Clin Exp Otorhinolaryngol

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Laryngotracheal separation (LTS) is the most immediately life-threatening airway injury. LTS is so rare that very few otolaryngologists have experience with it. LTS is one of the diagnostic and therapeutic challenges in airway diseases and its management remains to be established. We experienced a patient with complete LTS after attempted hanging. A high index of suspicion, adequate imaging, prompt airway establishment and early surgical repair are the most vital factors in managing a patient with LTS.

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Unusual presentation of blunt laryngeal injury with cricotracheal disruption by attempted hanging: a case report

Cited by 21 publications

References 16 publications

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings

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

Complete Laryngotracheal Separation Following Attempted Hanging

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