Avoiding Missed Diagnoses of Pharyngeal Foreign Bodies in Postmortem Investigations: A Case Report of Denture-Related Asphyxia

TL;DR

This case report highlights how a denture can cause fatal airway blockage and emphasizes the importance of thorough postmortem imaging and inspection.

Contribution

The case demonstrates the diagnostic value of combining PMCT with direct laryngeal inspection in detecting denture-related asphyxia.

Findings

An acrylic resin denture was found lodged in the laryngopharynx during postmortem examination.

PMCT detected a faint metallic artifact, prompting further inspection and revealing the missing denture.

The cause of death was determined to be asphyxia due to airway obstruction by the denture.

Abstract

Foreign body asphyxia due to pharyngeal denture impaction is an uncommon but potentially fatal event, especially in elderly individuals. This report describes a forensic case in which an acrylic resin denture was discovered impacted in the laryngopharynx during postmortem examination. A faint metallic artifact detected on postmortem computed tomography (PMCT) raised suspicion of a foreign body, prompting laryngeal inspection, which revealed the missing lower denture lodged in the laryngopharynx. The denture was composed mainly of radiolucent acrylic resin, with only a minimal metallic component, which made its detection difficult on imaging studies. No other fatal findings were identified, and the cause of death was most consistent with asphyxia due to airway obstruction. This case highlights the diagnostic value of combining PMCT with direct laryngeal inspection, especially when imaging is inconclusive. It also underscores the importance of recognizing subtle imaging signs and accounting for missing prosthetic devices during postmortem evaluations, particularly in elderly individuals. In countries like Japan, where postmortem assessments may rely solely on external examination and PMCT, this case emphasizes the need for vigilance regarding airway obstruction even in the absence of an autopsy.

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