[Soft tissue hemorrhage within the larynx following strangulation]

The inner soft tissues of the larynx (i.e., true vocal cord, false vocal cord, paralaryngeal space) were examined by special preparation of the larynx: thyroid cartilage was detached from the cricoid and the laryngeal cords, which could then be examined. Bleeding (not visible before) was found in 18 of 40 cases of persons killed by throttling or choking; bleeding occurred whenever blunt trauma of the throat had taken place (n = 8). Hemorrhage develops even in cases without damage to the laryngeal skeleton; this bleeding can result from direct compression of the larynx (large and not well defined bleeding) and can originate indirectly (small hemorrhages mostly in the vocal muscles). The finding of hemorrhages like this can help to demonstrate that the victim has undergone a violent attack on the throat.