CONCLUSIONS OF COMMISSION FORENSIC MEDICAL EXAMINATIONS IN DETERMINING SEVERITY OF INJURES HYOID-LARYNGEAL COMPLEX
About the author:
Gubin M. V., Malikhina O. I., Voytov E. O.
Type of article:
Victims with lethal and non-lethal closed blunt trauma of the hyoid-laryngeal complex often become the subject of forensic medical examination. Purpose of work: peculiarities of bodily injuries and forensic medical assessment of their severity in the victims with closed blunt trauma of the hyoid-laryngeal complex on the basis of morphological and clinical analysis of the conclusion of commission forensic medical examinations to determine ways of improving the efficiency of expert diagnosis of these traumas. Object and methods. The conclusion of 32 commission forensic medical examinations of the leading expert institution of Kharkiv region, performed during 2011-2018, in cases of closed blunt trauma of the hyoid-laryngeal complex, were retrospectively studied. 14 examinations of non-lethal injuries and 18 – of non-lethal injuries were analyzed. Results. According to the mechanism of trauma: in 17 (53.1 %) cases there was an impact effect of blunt solid objects to the neck, in 14 (43,8 %) cases – compression of the neck with hands, blunt solid objects or a loop, in 1 (3.1 %) case – compression of the neck with the hands and impact of blunt solid objects. The peculiarities of establishing the severity of bodily injury in this trauma were determined. Severe injuries were estimated in 11 (34.4 %) cases of death of the victims of mechanical asphyxia, and in one – from traumatic shock. Medium severity injuries were established by experts: in 6 (18.8 %) cases of lethal and in 6 (18.8 %) cases non-lethal injuries with laryngeal cartilage fractures; in 2 (6.2 %) observations of non-lethal injuries with acute edema, hematoma, stenosis of the larynx of the 2nd degree. 6 (18.8 %) cases of non-lethal laryngeal injuries with the development of acute post-traumatic laryngitis were qualified as light degree injuries. Conclusions. There is a lack of morpho-clinical criteria for the objective evaluation of injuries of the hyoid-laryngeal complex, in the available scientific and methodological literature, which leads to some difficulties in the forensic medical evaluation of injuries with the formation of fractures of the larynx cartilage and hyoid bone. On the basis of the obtained results the ways of further improvement of forensic evaluation of the mentioned bodily injuries were determined.
commission forensic medical examination, trauma to the hyoid-laryngeal complex, diagnostic criteria, severity degree of injuries.
- Naida AI, Malyk OR. Sudova medytsyna: kompleksnyi navch. posib. K.: Atika; 2012. 272 s. [in Ukrainian].
- Avdeev AI. Nettsel OV. Travma organov shei i eyo sudebno-meditsinskoe znachenie. Meditsinskaya ekspertiza i pravo. 2014;1:19-21. [in Russian].
- Smirnov RYu. Sudebnaya meditsina (sudebno-meditsinskaya otsenka vreda zdorovyu): uchebno-metodicheskoye posobiye. Yaroslavl: YarGU; 2018. 52 s. [in Russian].
- Klevno VA. Meditsinskie kriterii vreda zdorovyu: ekspertnaya i pravoprimenitelnaya praktika. M.: GEOTAR-Media; 2012. 112 s. [in Russian].
- Pigolkin YuI, Beleshnikov IL, Dubrovin IA. Sudebnaya meditsina. Natsionalnoe rukovodstvo. M.: GEOTAR-Media; 2018. 576 s. [in Russian].
- Pravyla sudovo-medychnoho vyznachennia stupenia tiazhkosti tilesnykh ushkodzhen. Nakaz MOZ Ukrainy № 6 vid 17.01.1995 r. «Pro rozvytok ta vdoskonalennia sudovo-medychnoi sluzhby Ukrainy». Kyiv: 1995. 220 s. [in Ukrainian].
- Yunina AI. Travmy organov shei i ih oslozhneniya. M.: Meditsina; 1972. 208 s. [in Russian].
- Aksakal C, Karaca I. Isolated vocal cord hematoma developing after blunt neck trauma. Turkish Journal of Emergency Medicine. 2019;19:30-2.
- Jain S, Singh P, Gupta M, Kamble B, Phatak SS. Comminuted laryngeal fracture following blunt trauma: A need for strict legislation on roads. Annals of Maxillofacial Surgery. 2017;7(1):124-8.
- Jalisi S, Zoccoli M. Management of laryngeal fractures a 10-year experience. J Voice. 2011;25(4):473-9.
- Mau T. Three-dimensional morphometric analysis of cricoarytenoid subluxation. J Voice. 2012;26:133-6.
- Parida PK, Kalaiarasi R, Alexander A. Management of Laryngotracheal Trauma: A Five-Year Single Institution Experience. Iran J Otorhinolaryngol. 2018;30(100):283-90.
- Govorun MI, Gorohov AA. Povrezhdenija LOR-organov i shei v mirnoe i voennoe vremja: rukovodstvo dlja vrachej. SPb.: «SpecLit»; 2010. 126 s. [in Russian].
- Klevno VA, Bogomolova IN. Opredelenie stepeni tjazhesti vreda zdorov’ju. Primenenie pravil i medicinskih kriteriev. Otvety na voprosy. Moskva: GJeOTAR-Media; 2010. 136 s. [in Russian].
- Protokoly nadannia medychnoi dopomohy «Otolarynholohiia»: Normatyvne vyrobnycho-praktychne vydannia. K.: MNIATs medychnoi statystyky; MVTs «Medinform»; 2009. 104 s. [in Ukrainian].
Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 381-384 pages, index UDK 340.66:616.222.72