Button batteries: the worst case scenario in nasal foreign bodies

To present four cases of button battery nasal foreign bodies that were referred to an otolaryngology department over a 6-month period.

Four cases are presented and discussed with a review of current literature.

Four children aged 2-4 years who were referred to an otolaryngology department over about 6 months were found to have a button battery in their nose. While there was mucosal damage in all the noses the likelihood of a septal perforation developing appears to be related to the time interval between insertion and removal. The two patients who did not develop a septal perforation had the battery removed after about 90 minutes and 3 days. The two patients who did develop a perforation had the battery removed after 4 hours and 24 hours. Battery thickness may also be important as the patient who had the battery removed at 3 days had a 2 mm thick battery whereas the other three all had a 5 mm thick battery.

As button batteries are ubiquitous it is imperative that consumers and medical practitioners are aware of the risks they pose if placed in the nose, and also elsewhere in the body.

As early removal of a button battery is likely to decrease the chances of a septal perforation developing a nasal foreign body should be considered to be a button battery until proven otherwise.