Korean J Leg Med.  2013 Aug;37(3):129-133. 10.7580/kjlm.2013.37.3.129.

The Significance of Fluid in the Sphenoid Sinuses in Death by Drowning

• Lee SH
• Ryu KW

• KMID: 2305464
• DOI: http://doi.org/10.7580/kjlm.2013.37.3.129

Abstract

The diagnosis of death by drowning is one of the hardest challenges in forensic pathology. Circumstantial factors and physical evidence such as autopsy findings are both important in drowning. However, drowning findings are not specific and no laboratory tests can specifically detect drowning. It has been suggested that fluid in the paranasal sinuses, especially the sphenoid sinuses, is a sign of drowning, in conjunction with other autopsy findings. This study aimed to determine the frequency of detection of fluid in the sphenoid sinuses in cases of death by drowning. From 2003 to 2012, 54 autopsied cases of drowning were selected and reviewed in the Department of Forensic Medicine, Kyungpook National University School of Medicine, Daegu. The most common autopsy findings were foaming at the mouth and nostrils (13%), frothy fluid in the airways (28%), pulmonary edema with overexpansion of lungs (87%), drowning liquid in the stomach and duodenum (52%) and hemorrhages in the petromastoid part of the temporal bone (93%). Fluid in the sphenoid sinuses was detected in 45/54 cases (83%). The plankton test was positive in 33/54 cases (87%), however, in 26 of these cases, plankton was found only in the lung tissue. In conclusion, detection of fluid in the sphenoid sinuses could be a diagnostic sign for death by drowning. The sphenoid sinuses are easily accessible on autopsy, so it is highly recommended to look for fluid in the sphenoid sinuses when performing an autopsy on bodies recovered from water.

Keyword

Drowning; Autopsy; Sphenoid sinus; Cause of death

MeSH Terms

Autopsy
Cause of Death
Drowning
Duodenum
Forensic Medicine
Forensic Pathology
Hemorrhage
Humans
Lung
Mouth
Paranasal Sinuses
Plankton
Pulmonary Edema
Sphenoid Sinus
Stomach
Temporal Bone