To identify patterns of hyoid bone and laryngeal cartilage injury identified on post mortem CT scans performed in the setting of fatal trauma to the neck as a consequence of manual strangulation, ligature strangulation and smothering.

A retrospective imaging and data assessment was performed at the Forensic Medicine Coroners Court Complex Sydney. A word search was performed on a deceased individual database targeting the keyword ‘strangulation’ between July 2015 and July 2022 to identify cases that were suspected to have had strangulation as either the main cause or contributing aetiology leading to death. The deaths included homicides and suicide by ligature (non-suspended). The post mortem CT results were initially reviewed with injuries documented and then correlated with the autopsy findings and...

Analysis of 26 cases with a provided history of ‘strangulation’ on autopsy with no confounding cause contributing to injuries sustained to the hyoid/larynx. 11/26 were suicide by ligature compression (non-suspended). 15/26 were confirmed homicides (7 male; 8 female) Of the homicides, 8/15 were due to manual compression; 5/15 were due to ligature strangulation; 2/15 were cases of smothering All the homicides had a formal post mortem (PM) undertaken. 10/15 of the cases had complete CT and PM correlation; 2/15 partially correlated (in both cases PM...

One of the main aims of the study, was to identify patterns of injury specific to the method of neck injury causing asphyxia. Previous studies have identified some patterns based on instrument used, and method of asphyxiation1. The advent of post-mortem CT has allowed for more accurate definition of hyoid-larynx complex injuries prior to formal autopsy 1,7. Increased accuracy in identification of injuries and possible mechanisms will assist police and coronial investigations in determining cause of death in such cases. While the case numbers of...

de Bakker, HM, Warmbrunn, M., van den Biggelaar, P et al. Fracture patterns of the hyoid-larynx complex after fatal trauma on the neck: retrospective radiological postmortem analysis of 284 cases. Int J Legal Med 2020;134(4):1465–1473. Ubelaker DH. Hyoid fracture and strangulation. J Forensic Sci 1992;37(5):1216–1222 DiMaio VJ. Homicidal asphyxia. Am J Forensic Med Pathol 2000;21(1):1–4 Pollanen MS, Chiasson DA. Fracture of the hyoid bone in strangulation: comparison of fractured and unfractured hyoids from victims of strangulation. J Forensic Sci 1996;41(1):110–3 Maxeiner H. "Hidden" laryngeal injuries...