Forensic-medical determination of the severity of closed injuries of the hyoid-laryngeal complex according to the data of a specialized clinic

Authors

DOI:

https://doi.org/10.26641/2307-0404.2023.3.289205

Keywords:

forensic-medical examination, trauma of the hyoid-laryngeal complex, diagnostic criteria, degree of severity of physical injuries

Abstract

Victims with closed blunt trauma of the hyoid-laryngeal complex often become the object of forensic examination. The purpose of the work was the forensic determination of the severity of injuries of the hyoid-laryngeal complex based on the materials of a specialized otolaryngological clinic in order to establish ways to improve the effectiveness of forensic diagnostics. 62 medical inpatient and outpatient cards of patients with injuries of the hyoid-laryngeal complex, who were treated in the Kharkiv clinical otolaryngological hospital No. 30 during 2011-2021, were processed. The mechanism of occurrence of injuries of the hyoid-laryngeal complex was as follows: in 51 (82.3% of cases there were blows to the neck with blunt hard objects (blows with fists and other objects), in 11 (17.7%) cases – squeezing of the neck with hands or blunt hard objects. The severity of injuries of the hyoid-laryngeal complex was determined from a forensic-medical point of view based on the observations of patients in a specialized hospital. Injuries of the hyoid-laryngeal complex in 3 (4.8%) patients with the occurrence of life-threatening phenomena, namely acute respiratory failure, were assessed as serious ones. Injuries in 8 (12.9%) patients were assessed as injuries of medium severity, mainly in cases of laryngeal cartilage fractures due to the lack of danger to life. Injuries in 38 (61.3%) patients were assessed as slight physical injuries that caused a short-term health disorder, mainly in cases of damage to the soft tissues of the larynx (hematoma, hemorrhage, swelling). Injuries in 13 (20.9%) patients in cases of acute post-traumatic laryngitis without pronounced morphological changes were assessed as slight ones. It was determined that additional diagnostic criteria for determining the severity of injuries of the hyoid-laryngeal complex, which have to be considered are: the dynamics and terms of restoration of post-traumatic morphological-clinical, and functional changes, the occurrence of life-threatening phenomena. The conducted scientific work made it possible to determine the ways of further improvement of diagnostics in the forensic-medical determination of the severity of the investigated injuries.

References

Tamilmani K. Practical Guide for Forensic Medicine and Toxicology. 2nd. Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2021. 260 p.

Chand S. Essentials of Forensic Medicine and Toxicology. 2nd. Elsevier Health Sciences, India; 2023. 650 p.

Famokunwa B, Kemp S, Selby J, Madani G, Sandhu G, Hull JH. Life‐threatening laryngeal injury in Elite Rugby Union: Prevention and management laryngeal trauma in rugby. Clin Case Rep. 2021;9:494-8. doi: https://doi.org/10.1002/ccr3.3565

Viejo-Moreno R, García-Fuentes C, Mudarra-Reche C, Terceros-Almanza LJ, Chico-Fernández M. Laryngeal injury in closed cervical traumatism Med Intensiva. 2019;43:503-7. doi: https://doi.org/10.1016/j.medin.2018.01.003

Dubey PK, Singh K, Bharti AK. Point-of-Care Ultrasonography for Evaluation of Blunt Tracheal Injury. Journal of Cardiothoracic and Vascular Anesthesia. 2021;35(8):2545-6. doi: https://doi.org/10.1053/j.jvca.2021.01.015

Shi J, Uyeda JW, Duran-Mendicuti A, Potter CA, Nunez DB. Multidetector CT of Laryngeal Injuries: Principles of Injury Recognition. Radiographics. 2019;39(3):879-92. doi: https://doi.org/10.1148/rg.2019180076

Dhattarwal SK, Jakhar JK, Yadav N. Practical aspects of Forensic Medicine For MBBS and MD Students Paperback. Bhilai: OrangeBooks Publication; 2021. 240 p.

[On the development and improvement of the forensic medical service of Ukraine. Rules of forensic medical determination of the severity of bodily injuries. Order of the Ministry of Health of Ukraine No. 6 of 1995 Jan 17]. Kyiv; 1995. 220 p. Ukrainian.

Biswas S, Saran M. Blunt trauma to the neck presenting as dysphonia and dysphagia in a healthy young woman; a rare case of traumatic laryngocele. Bull Emerg Trauma. 2020;8(2):129-31. doi: https://doi.org/10.30476/BEAT.2020.46455

Max Houck Forensic Pathology (Advanced Forensic Science Series). 1st Edition. USA; 2016. 436 p.

Payne-James J, Jones RM. Simpson's Forensic Medicine. 14th Edition. USA, Boca Raton: CRC Press; 2019. 353 p.

Stewart ME, Erath BD. Investigating Blunt Force Trauma to the Larynx: the role of inferior-superior vocal fold displacement on phonation. Journal of Biomechanics. 2020;18:1-28. doi: https://doi.org/10.1016/j.jbiomech.2021.110377

Aksakal C, Karaca I. Isolated vocal cord hematoma developing after blunt neck trauma. Turkish Journal of Emergency Medicine. 2019;19:30-2. doi: https://doi.org/10.1016/j.tjem.2018.08.004

Moser JB, Stefanidis K, Vlahos I. Imaging evaluation of tracheobronchial injuries. Radiographics. 2020;40:515-28. doi: https://doi.org/10.1148/rg.2020190171

[Medical care protocols "Otolaryngology". Normative production-practical edition]. Kyiv: MNIATs medychnoi statystyky; MVTs «Medinform»; 2009. 104 p. Ukrainian.

Published

2023-09-29

How to Cite

1.
Gubin M, Olkhovskyi V, Garyuk G, Gubin V. Forensic-medical determination of the severity of closed injuries of the hyoid-laryngeal complex according to the data of a specialized clinic. Med. perspekt. [Internet]. 2023Sep.29 [cited 2024Dec.22];28(3):94-109. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/289205

Issue

Section

CLINICAL MEDICINE