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Meredith M, Harris P, Day C, Milne N, Watkins T, Ong BB. A Possible Mechanism of Laryngohyoid Fractures in Hanging: A Preliminary Observation. Am J Forensic Med Pathol 2024; 45:254-258. [PMID: 38833353 DOI: 10.1097/paf.0000000000000944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
ABSTRACT Fractures of the hyoid bone, particularly the greater horns, and thyroid cartilage (superior horns) are known to be associated with hanging deaths. Depending on the literature, the frequency of these fractures varies from 0% to 83%. The mechanism underlying these fractures is believed to be direct compression or indirect traction from the ligature. The relationship of these structures with the cervical spine cannot be visualized with traditional internal examination, due to obstruction by surrounding soft tissue. Postmortem computed tomography scan offers an unobscured view of the relationship of the laryngohyoid structures with the cervical spine.We aim to illustrate the phenomenon of displacement of the laryngohyoid structures associated with fractures of the horns. In our case reports, the laryngohyoid structures were displaced, not only superiorly and posteriorly, but also in 2 of the cases, by tilting, when the suspension point was at the posterior or posterolateral aspect of the neck. This displacement had caused the greater horns of the hyoid bone and superior horns of the thyroid cartilage to be approximated against the cervical spine, particularly the transverse processes. We believe that, in these circumstances, the fractures were caused by pressure of the horns of the laryngohyoid structures against the cervical spine.
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Affiliation(s)
- Matt Meredith
- From the Forensic and Scientific Services, Queensland Public Health and Scientific Services, Queensland, Australia
| | - Peter Harris
- From the Forensic and Scientific Services, Queensland Public Health and Scientific Services, Queensland, Australia
| | - Christopher Day
- From the Forensic and Scientific Services, Queensland Public Health and Scientific Services, Queensland, Australia
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Hansen JP, Larsen ST, Jacobsen C. Diagnostic accuracy of post-mortem computed tomography for fractures of the hyoid-larynx complex. Int J Legal Med 2024:10.1007/s00414-024-03293-1. [PMID: 39014249 DOI: 10.1007/s00414-024-03293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/09/2024] [Indexed: 07/18/2024]
Abstract
Post-mortem computed tomography (PMCT) is routinely used at many forensic institutions to guide the following autopsy and is especially useful for diagnosing fractures. This systematic review aims to investigate the sensitivity and specificity of a PMCT scan in fracture diagnosis of the hyoid-larynx complex (HLC) compared to traditional autopsy in cases involving traumatic neck injuries. We searched PubMed, SCOPUS and Web of Science and included papers with cases n ≥ 3 published between January 2000 and April 2023 reporting on PMCT and autopsy findings of fractures of the HLC. The search provided 259 results of which 10 were included. Overall sensitivity and specificity were 0.70 [0.59; 0.79] and 0.92 [0.80; 0.97] for hyoid bone fractures and 0.80 [0.62; 0.91] and 0.76 [0.63; 0.85] for the thyroid cartilage. The results show great variation, and a large range between studies. These results indicate that PMCT cannot replace autopsy in cases with HLC fractures. Future larger prospective studies are needed, examining fracture details, scan protocols and different slice thicknesses using uniform reporting.
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Affiliation(s)
- Josephine Ploug Hansen
- Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Frederik V's Vej 11, Copenhagen, 2100, Denmark
| | - Sara Tangmose Larsen
- Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Frederik V's Vej 11, Copenhagen, 2100, Denmark.
| | - Christina Jacobsen
- Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Frederik V's Vej 11, Copenhagen, 2100, Denmark
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Giovannini E, Franchetti G, Ridolfi M, Berardi D, Pelletti G, Gualandi A, Giraudo C, Cecchetto G, Fais P. An unusual case of corpse concealment driven by emotional distress. Leg Med (Tokyo) 2024; 67:102379. [PMID: 38183946 DOI: 10.1016/j.legalmed.2023.102379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/08/2024]
Abstract
Corpse concealment involves hiding a body for criminal purposes for many different reasons, such as destroy evidence of a murder or avoid the discovery of the victim. Although defendants could argue that they did not conceal the corpse with any criminal intent, but rather to spare themselves or others from emotional distress or to honor the wishes of the deceased. However, these arguments are often challenging to substantiate, and defendants may encounter significant legal obstacles when attempting to justify their actions. Herein, we report a case involving the concealment of a woman's corpse by her father. Autopsy and histological investigations were significantly limited due to the advanced decomposition of the body. Nevertheless, by integrating these data with radiological findings obtained from total body CT and micro-CT of the larynx-hyoid complex, hanging was deemed the cause of death. Additionally, the psychological evaluation of the father indicated that the act of concealment was motivated by emotions rather than criminal intent.
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Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, Padova, Italy.
| | - Marcello Ridolfi
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
| | | | - Guido Pelletti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Alberto Gualandi
- Institute of Pathology, DAME, University Hospital of Udine, 33100 Udine, UD, Italy.
| | - Chiara Giraudo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, Padova, Italy.
| | - Giovanni Cecchetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Legal, Medicine and Toxicology, University of Padova, Via Falloppio 50, Padova, Italy.
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
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