@article{ref1,
title="The role of paranasal sinus fluid in determining drowning as the cause of death: a systematic review and meta-analysis",
journal="Journal of forensic and legal medicine",
year="2023",
author="da Trindade, Rafael Queiroz and Duarte Morais Vieira, Maria Gabriela and Vieira, Raíssa Bastos and Vicentin-Junior, Carlos Antonio and Damascena, Nicole Prata and Santiago, Bianca Marques and Martins-Filho, Paulo Ricardo and Palhares Machado, Carlos Eduardo",
volume="99",
number="",
pages="e102591-e102591",
abstract="Drowning is a significant global cause of unintentional injury fatalities, and accurate forensic diagnosis of drowning remains a challenge due to the nonspecific nature of post-mortem findings obtained through classical autopsy methods. Our manuscript addresses this issue by focusing on the emerging use of paranasal sinus fluid as a valuable tool in determining the cause of death, specifically in distinguishing drowning from non-drowning cases. The study provided a comprehensive summary of available evidence from observational studies that compared findings in the paranasal sinuses between drowning and non-drowning victims, analyzing parameters such as the presence of fluid, fluid volume, and density. The study encompassed a total of 14 selected studies involving 1044 subjects and utilized rigorous risk of bias assessment and data synthesis techniques. The meta-analysis demonstrated a strong association between the presence of fluid in the paranasal sinuses and drowning (OR = 17.1; 95% CI 7.2 to 40.5; p < 0.001). In addition, drowning victims had a significantly greater volume of fluid (SMD = 0.8; 95% CI 0.5 to 1.2; p < 0.001) and lower fluid density (SMD = -1.4; 95% -2.5 to -0.4; p = 0.008) compared to non-drowning cases. The results support the utility of paranasal sinus fluid analysis as a valuable diagnostic method in cases where drowning is suspected but cannot be definitively confirmed through traditional approaches.<p /> <p>Language: en</p>",
language="en",
issn="1752-928X",
doi="10.1016/j.jflm.2023.102591",
url="http://dx.doi.org/10.1016/j.jflm.2023.102591"
}