Temporal bone histopathologic findings in drowning victims.

The human temporal bones of five drowning victims, the largest such series, to our knowledge, were evaluated to determine what histopathologic changes occurred. Thickening of the periosteal epithelium, especially on the surgical dome of the otic capsule, was evident in all cases. There was also hemorrhage in the middle ear cavity in four of the cases. In the fifth case, a cholesteatoma and ruptured tympanic membrane were observed, but there was no evidence of hemorrhage. It is proposed that an intact tympanic membrane is needed to create sufficient negative pressure in the middle ear cavity to cause rupture of the blood vessels and hemorrhage. Such bleeding is indicative of drowning when the tympanic membrane is intact.