The authors illustrate the anatomic interest of the hyoid-larynx complex in the differential diagnosis of traumatic lesions, purely anatomic anomalies, and lesions resulting from natural causes. Forty larynges from corpses undergoing autopsy at the Institute of Legal Medicine of the University of Trieste were studied during the period May 1996 to May 2001. The larynges were excised and examined through radiographic magnification with dedicated mammographic equipment. Triticeous cartilages were evidenced in 12 (30%), they were bilateral in 7 (17.5%) and monolateral in 5 (12.5%). These cartilages were more frequent in men (8 out of 26; 31%) than in women, 4 out of 14 (28.5%). Total fusion of the body of the hyoid bone with the greater horns was revealed in 10 (25%), partial fusion in 4 (10%), and evident articular rima between the body and the greater horns of the hyoid bone in 14 (35%). The lesser horns of the hyoid bone were symmetrical in 29 (72.5%), asymmetric in 11 (27.5), absent in 1 (2.5%). While confirming the validity of the radiographic method used, we conclude that great care should be taken when diagnosing traumatic lesions of the hyoid-larynx complex. This diagnosis is often difficult to establish owing to the considerable frequency of anatomic anomalies of the complex.

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This paper proposes the use of radiographic magnification to detect the effects of neck traumas. This technique, both fast and economical, has proved to be particularly useful in all those cases where post mortem examinations failed to detect valid evidence of lesions of the hyoid-larynx complex. This is the case with corpses in an advanced stage of putrefaction where death occurred as a result of pressure or when a soft object is placed between the victim's neck and the assailant's hands. The radiological study was performed "on site" on four cases of medicolegal interest and its potential was confirmed.