Potential usefulness of otoscopy in the evaluation of hanging deaths: A report of two cases.

The significance of examination of the tympanic membrane (TM) has been previously reported in cases of strangulation, traumatic asphyxia, and drowning. We report otoscopic findings in two victims of suicidal hanging, including hemotympanum, bleeding from superficial vessels of the TM, perforation of the TM, and gross bulging of the pars-tensa with a bluish hue. These two cases also show petechial hemorrhages in the TM, which is a previously reported finding in cases of hanging. Postmortem otoscopic examination of victims of hanging may provide information useful in the determination of vitality of hanging.