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

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.