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Combining virtual endoscopy and postmortem computed tomography to identify airway obstruction by a peritonsillar
Xin Zhao1,2, Zhiming Chen1,2, Bo Wang1,2
1Department of Forensic Medicine, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China.
Abstract:
Peritonsillar abscess (PTA) is the most common deep neck infection, with well-known complications such as airway stenosis and aspiration pneumonia. However, death due to asphyxia caused by PTA is extremely rare in forensic research reports. Traditionally, the autopsy is the standard diagnostic method for pharyngeal lesions in forensic practice. The incorporation of postmortem computed tomography (PMCT) into the medicolegal death investigation has demonstrated unique diagnostic advantages for specific findings. In addition, virtual endoscopy (VE) shows great potential for supporting hollow organ assessment and postmortem diagnosis. Here, we report a case of asphyxial death due to airway obstruction caused by PTA. While autopsy, histopathological examination, and bacterial culture of fluid collected from the abscess effectively diagnosed PTA as the cause of airway obstruction leading to death, this case illustrates that PMCT combined with VE can be a valuable adjunct for in situ diagnosis.
Insights
Peritonsillar abscess (PTA) can cause fatal airway obstruction. Postmortem CT with virtual endoscopy aids in diagnosing this rare cause of asphyxial death.
Area of Science:
- Forensic pathology
- Medical imaging
- Otolaryngology
Background:
- Peritonsillar abscess (PTA) is a common deep neck infection.
- Complications like airway stenosis are known, but death from PTA-induced asphyxia is rare.
Observation:
- A rare case of asphyxial death due to airway obstruction from PTA is presented.
- Traditional autopsy, histopathology, and bacterial cultures confirmed PTA as the cause of death.
Findings:
- Postmortem computed tomography (PMCT) and virtual endoscopy (VE) were utilized for diagnosis.
- PMCT and VE demonstrated significant value in identifying the airway obstruction caused by PTA.
Implications:
- This case highlights the potential of PMCT and VE as adjuncts in medicolegal investigations.
- Advanced imaging techniques can provide valuable in situ diagnostic information for rare forensic cases.
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