Journal List > Korean J Leg Med > v.37(3) > 1004701

Korean J Leg Med. 2013 Aug;37(3):129-133. Korean.
Published online August 29, 2013.
© Copyright 2013 by the Korean Society for Legal Medicine
The Significance of Fluid in the Sphenoid Sinuses in Death by Drowning
Sang Han Lee,1 and Kwang Woo Ryu2
1Department of Forensic Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
2Department of Pathology, Kyungpook National University Hospital, Daegu, Korea.

Corresponding author (Email: )
Received July 25, 2013; Revised August 08, 2013; Accepted August 23, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


The diagnosis of death by drowning is one of the hardest challenges in forensic pathology. Circumstantial factors and physical evidence such as autopsy findings are both important in drowning. However, drowning findings are not specific and no laboratory tests can specifically detect drowning. It has been suggested that fluid in the paranasal sinuses, especially the sphenoid sinuses, is a sign of drowning, in conjunction with other autopsy findings. This study aimed to determine the frequency of detection of fluid in the sphenoid sinuses in cases of death by drowning. From 2003 to 2012, 54 autopsied cases of drowning were selected and reviewed in the Department of Forensic Medicine, Kyungpook National University School of Medicine, Daegu. The most common autopsy findings were foaming at the mouth and nostrils (13%), frothy fluid in the airways (28%), pulmonary edema with overexpansion of lungs (87%), drowning liquid in the stomach and duodenum (52%) and hemorrhages in the petromastoid part of the temporal bone (93%). Fluid in the sphenoid sinuses was detected in 45/54 cases (83%). The plankton test was positive in 33/54 cases (87%), however, in 26 of these cases, plankton was found only in the lung tissue. In conclusion, detection of fluid in the sphenoid sinuses could be a diagnostic sign for death by drowning. The sphenoid sinuses are easily accessible on autopsy, so it is highly recommended to look for fluid in the sphenoid sinuses when performing an autopsy on bodies recovered from water.

Keywords: Drowning; Autopsy; Sphenoid sinus; Cause of death


Fig. 1
The bar graph shows the distribution of victims of drowning by location.
Click for larger image

Fig. 2
The bar graph shows the frequency of the autopsy findings in drowning.
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Fig. 3
The bar graph shows the frequency of the results of plankton test in death by drowning. Each name of the organs means that plankton was detected.
Click for larger image


Table 1
Age and Gender Distribution of Victims of Drowning
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