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Airway Injuries Severe Consequence of Button Battery Ingestion

Tracheoesophageal fistulae and vocal cord paralyses are most common airway sequelae; vocal cord paralysis occurs after shorter exposure

FRIDAY, May 27, 2022 (HealthDay News) — Airway injuries are a severe consequence of ingestion of button batteries (BBs), with tracheoesophageal fistulae and vocal cord paralyses the most common airway injuries, according to a review published online May 26 in JAMA Otolaryngology-Head and Neck Surgery.

Justine Philteos, M.D., from the Hospital for Sick Children at the University of Toronto, and colleagues conducted a systematic review of studies with pediatric patients who developed airway injuries after BB ingestion. One hundred ninety-five patients (95 male) were included in the analysis.

The researchers found that the mean age at ingestion of BBs was 17.8 months. From BB ingestion to removal, there was a mean of 5.8 days. Tracheoesophageal fistulae and vocal cord paralyses (155 and 39 [16 unilateral and 23 bilateral], respectively) were the most common airway sequelae observed in this series. Vocal cord paralysis occurred after a shorter mean duration of ingestion compared with that of the general cohort (17.8 versus 138.7 hours). Subsequent tracheoesophageal fistula or vocal cord paralysis was likely among children presenting with airway symptoms.

“Vocal cord injuries can occur even after a very short duration of exposure, reinforcing the importance of otolaryngologic follow-up for these children,” the authors write. “Prioritization of timely BB removal is essential to decrease the devastating consequences of these injuries.”

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