Chulalongkorn Medical Journal


Background : Hanging is the most frequent suicidal method. It can cause tympanicmembrane (TM) injuries. Otoscopic examination is a non-invasive procedureto explore TM injuries that may be related to the pathological changesfrom hanging.Objective : To evaluate the value of TM injuries as a diagnostic tool in hanging cases.Methods : We prospectively examined 20 of hanging cases and 12 of non-asphyxiatingdeaths by otoscopic examination, photographed and blindly evaluated TMinjuries by an otolaryngologist from grade 0 to grade 3 according to severity.P – value, confidence of interval, sensitivity, specificity, positive predictivevalue (PPV), negative predictive value (NPV), area under the curve, andodd ratio (OR) were used to explore the correlation between TM injuriesand hanging.Results : There was higher number of TM injuries in the hanging cases than nonasphyxiatingcases. (OR = 5.293 at 95% CI, 1.290 – 21.72413 withP - value = 0.0149 for right ear and OR = 3.579 at 95% CI, 1.354 – 12.645,P - value = 0.0091 for left ear. Diagnostic odds ratio = 8.748)Conclusions : The injuries found in ears tympanic membrane seemed to be the indicativefindings in hanging. A larger sample size will be required to yield moreaccurate study results.


Faculty of Medicine, Chulalongkorn University

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