Research Article
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Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals

Year 2021, Volume: 31 Issue: 4, 81 - 85, 21.12.2021
https://doi.org/10.26650/Tr-ENT.2021.1027401

Abstract

Objective: Button Batteries (BB) stuck in the Ear Canal (EC) have a special importance among foreign bodies in terms of causing complications depending on the length of time they remain in place, especially in children. In the present study, the purpose was to compare the damaging effects of frequently used BB chemicals on EC and the differences among them.Material and

Methods: After 4 EC models prepared from freshly frozen cadaveric bovine ears were thawed, Lithium, Alkaline, Silver-oxide, and Zinc-air BBs with similar size were placed respectively in the canals as the negative poles in contact with the skin. The voltage, tissue temperatures, and pHs of the BBs were measured and visual damage was photographed at the 3rd, 6th, 12th, and 24th hours. The BBs were removed at the end of the 24th hour, and EC models were examined histopathologically in a single-blind manner.

Results: Although the visual damage could be observed in the first 1.5 hours in ECs with Lithium, Alkaline, and Silver-oxide BBs, it was observed that this time extended to 2.5 hours in Zinc-air. The highest pH value was measured in lithium BB at the end of 24 hours, and the lowest pH value was measured in Zinc-air BB. The least voltage loss was measured in alkaline BB, and not all BB types caused significant changes in tissue temperatures for 24 hours. No significant tissue necrosis depth was detected in Zinc-air BB, but it was most common in Lithium, Silver-oxide, and Alkaline BBs, respectively.

Conclusion: All BB chemicals, especially Lithium BB, might cause alkaline necrosis at varying degrees by increasing the pH in EC models without any heat change. Zinc-air BBs, which are generally used in hearing aids, appear to have less damage potential compared to others

References

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  • 15. Jatana KR, Litovitz T, Reilly JS, Koltai PJ, Rider G, Jacobs IN. Pediatric button battery injuries: 2013 task force update. Int J Pediatr Otorhinolaryngol 2013;77(9):1392-9. google scholar
  • 16. Svider PF, Johnson AP, Folbe AJ, Carron MA, Eloy JA, Zuliani G. Assault by battery: battery-related injury in the head and neck. Laryngoscope 2014;124(10):2257-61. google scholar
  • 17. Bhisitkul DM, Dunham M. An unsuspected alkaline battery foreign body presenting as malignant otitis externa. Pediatr Emerg Care 1992;8(3):141-2. google scholar
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  • 23. Voelker J, Voelker C, Engert J, Schendzielorz P, Hagen R, Rak K. Severe tracheobronchial harm due to lithium button battery aspiration: An in vitro study of the pathomechanism and injury pattern. Int J Pediatr Otorhinolaryngol 2020;139:110431. google scholar
  • 24. Eliason MJ, Melzer JM, Winters JR, Gallagher TQ. Identifying predictive factors for long-term complications following button battery impactions: A case series and literature review. Int J Pediatr Otorhinolaryngol 2016;87:198-202. google scholar
  • 25. Shaffer AD, Jacobs IN, Derkay CS, Goldstein NA, Giordano T, Ho S, et al. Management and Outcomes of Button Batteries in the Aerodigestive Tract: A Multi-institutional Study. Laryngoscope 2021;131(1):E298-306. google scholar
  • 26. Liao W, Wen G, Zhang X. Button battery intake as foreign body in Chinese children: review of case reports and the literature. Pediatr Emerg Care 2015;31(6):412-5. google scholar
Year 2021, Volume: 31 Issue: 4, 81 - 85, 21.12.2021
https://doi.org/10.26650/Tr-ENT.2021.1027401

Abstract

References

  • 1. Sancaktar ME, Bayraktar C, Bakırtaş M. Injury Mechanism of Button Batteries in the Nasal Cavity and Possible Mitigation Strategies During Impaction. Laryngoscope 2020;130(10):2487-93. google scholar
  • 2. Buttazzoni E, Gregori D, Paoli B, Soriani N, Baldas S, Rodriguez H, et al. Susy Safe Working Group. Symptoms associated with button batteries injuries in children: An epidemiological review. Int J Pediatr Otorhinolaryngol 2015;79(12):2200-7 google scholar
  • 3. Morris S, Osborne MS, McDermott AL. Will children ever learn? Removal of nasal and aural foreign bodies: a study of hospital episode statistics. Ann R Coll Surg Engl 2018;100(8):1-3. google scholar
  • 4. Thabet MH, Basha WM, Askar S. Button battery foreign bodies in children: hazards, management, and recommendations. Biomed Res Int 2013;2013:846091. google scholar
  • 5. Lin VY, Daniel SJ, Papsin BC. Button batteries in the ear, nose and upper aerodigestive tract. Int J Pediatr Otorhinolaryngol 2004;68(4):473-9. google scholar
  • 6. Litovitz TL. Battery ingestions: product accessibility and clinical course. Pediatrics 1985;75(3):469-76. google scholar
  • 7. Jatana KR, Rhoades K, Milkovich S, Jacobs IN. Basic mechanism of button battery ingestion injuries and novel mitigation strategies after diagnosis and removal. Laryngoscope 2017;127(6):1276-82. google scholar
  • 8. Huang T, Li WQ, Xia ZF, Li J, Rao KC, Xu EM. Characteristics and outcome of impacted button batteries among young children less than 7 years of age in China: a retrospective analysis of 116 cases. World J Pediatr 2018;14(6):570-5. google scholar
  • 9. Premachandra DJ, McRae D. Severe tissue destruction in the ear caused by alkaline button batteries. Postgrad Med J 1990;66(771):52-3. google scholar
  • 10. Penteado SP, Bento RF. Performance analysis of ten brands of batteries for hearing aids. Int Arch Otorhinolaryngol 2013;17(3):291-304. google scholar
  • 11. Svider PF, Vong A, Sheyn A, Bojrab DI 2nd, Hong RS, Eloy JA, et al. What are we putting in our ears? A consumer product analysis of aural foreign bodies. Laryngoscope 2015;125(3):709-14. google scholar
  • 12. Strachan DR, Kenny H, Hope GA. The hearing-aid battery: a hazard to elderly patients. Age Ageing 1994;23(5):425-6. google scholar
  • 13. Holdstein Y, Mazzawi S, Watad W, Shupak A. Wrong impression: middle ear foreign body following hearing aid fitting. Otolaryngol Head Neck Surg 2013;149(4):647-8. google scholar
  • 14. Wasson JH, Gall V, McDonald R, Liang MH. The prescription of assistive devices for the elderly: practical considerations. J Gen Intern Med 1990;5(1):46-54. google scholar
  • 15. Jatana KR, Litovitz T, Reilly JS, Koltai PJ, Rider G, Jacobs IN. Pediatric button battery injuries: 2013 task force update. Int J Pediatr Otorhinolaryngol 2013;77(9):1392-9. google scholar
  • 16. Svider PF, Johnson AP, Folbe AJ, Carron MA, Eloy JA, Zuliani G. Assault by battery: battery-related injury in the head and neck. Laryngoscope 2014;124(10):2257-61. google scholar
  • 17. Bhisitkul DM, Dunham M. An unsuspected alkaline battery foreign body presenting as malignant otitis externa. Pediatr Emerg Care 1992;8(3):141-2. google scholar
  • 18. Sharpe SJ, Rochette LM, Smith GA. Pediatric battery-related emergency department visits in the United States, 1990-2009. Pediatrics 2012;129(6):1111-7. google scholar
  • 19. Labadie M, O’Mahony E, Capaldo L, Courtois A, Lamireau T, Nisse P, et al. Severity of button batteries ingestions: data from French Poison Control Centres between 1999 and 2015. Eur J Emerg Med 2018;25(4):e1-8. google scholar
  • 20. Litovitz T, Whitaker N, Clark L. Preventing battery ingestions: an analysis of 8648 cases. Pediatrics 2010;125(6):1178. google scholar
  • 21. Anfang RR, Jatana KR, Linn RL, Rhoades K, Fry J, Jacobs IN. pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope 2019;129(1):49-57. google scholar
  • 22. Jatana KR, Barron CL, Jacobs IN. Initial clinical application of tissue pH neutralization after esophageal button battery removal in children. Laryngoscope 2019;129(8):1772-6 google scholar
  • 23. Voelker J, Voelker C, Engert J, Schendzielorz P, Hagen R, Rak K. Severe tracheobronchial harm due to lithium button battery aspiration: An in vitro study of the pathomechanism and injury pattern. Int J Pediatr Otorhinolaryngol 2020;139:110431. google scholar
  • 24. Eliason MJ, Melzer JM, Winters JR, Gallagher TQ. Identifying predictive factors for long-term complications following button battery impactions: A case series and literature review. Int J Pediatr Otorhinolaryngol 2016;87:198-202. google scholar
  • 25. Shaffer AD, Jacobs IN, Derkay CS, Goldstein NA, Giordano T, Ho S, et al. Management and Outcomes of Button Batteries in the Aerodigestive Tract: A Multi-institutional Study. Laryngoscope 2021;131(1):E298-306. google scholar
  • 26. Liao W, Wen G, Zhang X. Button battery intake as foreign body in Chinese children: review of case reports and the literature. Pediatr Emerg Care 2015;31(6):412-5. google scholar
There are 26 citations in total.

Details

Primary Language English
Subjects Otorhinolaryngology
Journal Section Research Article
Authors

Gökhan Akgül

Mustafa Bakırtaş 0000-0003-3185-6947

Publication Date December 21, 2021
Submission Date November 23, 2021
Published in Issue Year 2021 Volume: 31 Issue: 4

Cite

APA Akgül, G., & Bakırtaş, M. (2021). Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals. The Turkish Journal of Ear Nose and Throat, 31(4), 81-85. https://doi.org/10.26650/Tr-ENT.2021.1027401
AMA Akgül G, Bakırtaş M. Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals. Tr-ENT. December 2021;31(4):81-85. doi:10.26650/Tr-ENT.2021.1027401
Chicago Akgül, Gökhan, and Mustafa Bakırtaş. “Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals”. The Turkish Journal of Ear Nose and Throat 31, no. 4 (December 2021): 81-85. https://doi.org/10.26650/Tr-ENT.2021.1027401.
EndNote Akgül G, Bakırtaş M (December 1, 2021) Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals. The Turkish Journal of Ear Nose and Throat 31 4 81–85.
IEEE G. Akgül and M. Bakırtaş, “Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals”, Tr-ENT, vol. 31, no. 4, pp. 81–85, 2021, doi: 10.26650/Tr-ENT.2021.1027401.
ISNAD Akgül, Gökhan - Bakırtaş, Mustafa. “Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals”. The Turkish Journal of Ear Nose and Throat 31/4 (December 2021), 81-85. https://doi.org/10.26650/Tr-ENT.2021.1027401.
JAMA Akgül G, Bakırtaş M. Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals. Tr-ENT. 2021;31:81–85.
MLA Akgül, Gökhan and Mustafa Bakırtaş. “Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals”. The Turkish Journal of Ear Nose and Throat, vol. 31, no. 4, 2021, pp. 81-85, doi:10.26650/Tr-ENT.2021.1027401.
Vancouver Akgül G, Bakırtaş M. Investigation of Injuries Due to Different Types of Button Batteries Stuck in Ear Canals. Tr-ENT. 2021;31(4):81-5.