Ear Bleeding: A Sign Not to be Underestimated in Cases of StrangulationDuband, Sébastien MD*†; Timoshenko, Andréi P. MD‡§; Morrison, Alan L. MD*; Prades, Jean-Michel MD, PhD‡§; Debout, Michel MD, PhD†; Peoc'h, Michel MD, PhD*†The American Journal of Forensic Medicine and Pathology: June 2009 - Volume 30 - Issue 2 - p 175-176 doi: 10.1097/PAF.0b013e3181875a8b Case Report Abstract Author Information Otorrhagia is commonly associated with cranial trauma and diving accidents. In some forensic manuals, bleeding in the ears is anecdotally associated with strangulation. We report 2 cases of criminal strangulation with hemotympanum and otorrhagia, emphasizing the importance of this sign with strangulation. We present the proposed pathophysiology of the injuries and the value of otoscopic evaluation to complete the external examination in forensic cases suspicious for strangulation. From the Departments of *Pathology, †Forensic Medicine, and ‡Otolaryngology-Head and Neck Surgery, Saint-Etienne University Hospital Center, Bellevue Hospital, St-Etienne France; and the §Department of Anatomy, Jean Monnet University, St-Etienne, France. Manuscript received January 2, 2007; accepted August 9, 2007. Reprints: Sébastien Duband, MD, Department of Pathology, Saint-Etienne University Hospital Center, Bellevue Hospital, 42055 St-Etienne Cedex 2, France. E-mail: firstname.lastname@example.org. © 2009 Lippincott Williams & Wilkins, Inc.