TY  - JOUR
PY  - 2020//
TI  - Management and outcomes of button batteries in the aerodigestive tract: a multi-institutional study
JO  - Laryngoscope
A1  - Shaffer, Amber D.
A1  - Jacobs, Ian N.
A1  - Derkay, Craig S.
A1  - Goldstein, Nira A.
A1  - Giordano, Terri
A1  - Ho, Sandra
A1  - Kim, Bong J.
A1  - Park, Albert H.
A1  - Simons, Jeffrey P.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVES/HYPOTHESIS: To describe the clinical presentation, management, and complications associated with button battery impaction in the aerodigestive tract in children. STUDY DESIGN: Retrospective case series. <br><br>METHODS: This multi-institutional study, endorsed by the American Society of Pediatric Otolaryngology research consortium, is a retrospective medical record review, including all children at five tertiary-care institutions presenting with button batteries impacted in the aerodigestive tract between January 2002 and December 2014. Battery type/size, duration and location of impaction, presenting symptoms, treatment, complications, and outcomes were examined. <br><br>RESULTS: Eighty-one patients were included (64.2% male), with ingestion witnessed in 20 (24.7%). Median age at presentation was 3 years (range, 1 week-14 years). Median time from diagnosis to removal was 2.5 hours (range, 0.4-72 hours). Locations included the esophagus (n = 48), hypopharynx (n = 1), stomach (n = 6), nasal cavity (n = 22), and ear canal (n = 4). Most common symptoms for esophageal/hypopharyngeal impactions included dysphagia (26.5%), nausea/vomiting (26.5%), drooling (24.5%), cough (18.4%), and fever (18.4%). Most common symptoms for nasal impactions included epistaxis (54.6%), rhinorrhea (40.9%), nasal pain (27.3%), and fever (22.7%). Almost all esophageal impactions were from 3-V (89.5%), 20-mm (81.8%) lithium batteries. Severe esophageal complications included stricture (28.6%), perforation (24.5%), tracheoesophageal fistula formation (8.2%), pneumothorax (4.1%), and bilateral true vocal fold paresis (4.1%). Nasal complications included necrosis (59.1%), septal perforation (27.3%), and saddle nose deformity (4.5%). Duration of impaction correlated with an increased likelihood of persistent symptoms only for nasal batteries (P =.049). <br><br>CONCLUSIONS: Button batteries in the upper pediatric aerodigestive tract or ear canal should be considered a surgical emergency, requiring urgent removal and careful vigilance for complications. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020.<br><br>© 2020 The American Laryngological, Rhinological and Otological Society, Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 0023-852X
UR  - http://dx.doi.org/10.1002/lary.28568
ID  - ref1
ER  -