Histopathological study of changes in temporal bone in cases of drowning

Drowning is a global health problem which contributes to about 360000 deaths per annum worldwide viz., about 9% of global burden of deaths, according to WHO census of 2015. Establishment of drowning as a cause of death is a real challenge for the medical examiners on autopsy. Even though, there are so many corroborative evidences to establish the diagnosis of drowning in fresh dead bodies, it is still very difficult to establish the same in decomposed ones. In this study, various pathological changes in the temporal bones of about 11 cases of drowning were discussed. These changes can be very much helpful in clinching the postmortem diagnosis of “Death due to drowning”. It has been established that, a spectrum of findings can occur ranging from mere oedema of soft tissues of mastoid air cells and middle ear, frank haemorrhage of mastoid air cells alone, with or without middle ear haemorrhage and inner ear oedema and haemorrhage in extreme cases as the pressure differential across the tympanic membrane increases. These findings were recorded by both gross and histopathological evidences. We also observed that, depending upon the degree of struggle (violent inhalation and exhalation of water) and the magnitude of pressure differential across the tympanic membrane, the degree of temporal bone pathology varies from mere oedema to frank haemorrhage within the ear cavities. However, alcoholism and incapacitation prior to get into the water, found to play a major role in presence or absence of such temporal bones changes in drowning.