The hyoid bone is a U-shaped bone in the neck that sits between the chin and the thyroid cartilage. It is one of the few bones in the human body that does not articulate with another bone it is anchored only by muscles and ligaments.
Why It Matters in Epstein’s Case: Independent forensic pathologist Dr. Michael Baden hired by Epstein’s brother Mark to review the autopsy concluded that Epstein’s injuries were inconsistent with suicide by hanging. Specifically:
- Epstein’s hyoid bone was fractured
- Multiple other small bones in the neck (horns/cornua of the thyroid cartilage) were fractured
- Baden stated that this pattern of injuries, particularly the hyoid fracture, was more commonly associated with homicidal strangulation than with suicide by hanging
The Official Position: The New York City Medical Examiner, Dr. Barbara Sampson, maintained the ruling of suicide by hanging, acknowledging the hyoid fracture but stating it was not inconsistent with suicide in an older man.
The Significance: Hyoid fractures occur in approximately 1 in 4 or 5 suicide hangings, according to forensic literature but the frequency is higher in strangulations. The combination of multiple bone fractures led Baden and others to question the suicide conclusion.
The debate has never been definitively resolved.