Anthropological examination of the hyoid bone, thyroid cartilage, and cricoid cartilage in suicidal hangings

Abstract

Thorough evaluation of the hyoid bone, thyroid cartilage, and cricoid cartilage is critical in trauma interpretation as fractures of the neck block are commonly associated with manual strangulation, suicidal hanging, and direct blunt force trauma. The frequency of fractures to laryngohyoid structures is differentially reported in the literature. Between 2019 and 2021, the neck blocks from 56 suicidal hangings were subjected to an anthropological analysis for trauma. The protocol for examining these cases involved radiographs prior to removal of the soft tissues, followed by removal of all soft tissue overlying the skeletal and cartilaginous structures. This prospective study of the hyoid bone, thyroid cartilage, and cricoid cartilage from suicidal hangings found fractures in 71.4% of the cases. The correlation between different variables (e.g., age, sex, stature, weight, ligature furrow size, type of suspension) and the frequency of fractures was analyzed. Findings showed that there was not a strong correlation between the presence of fractures and sex, height, or weight of the decedent. Although not statistically significant, possible trends were observed based on the type of suspension and ligature furrow size. Age showed a statistically significant correlation with fractures. Overall, the number of fractures observed per case ranged from 0 to 6. The thyroid was the most common location for fractures. Although infrequent, cricoid fractures were observed in association with some cases. Differences in published laryngohyoid fracture frequencies appear to be primarily related to variation in data collection procedures.