Clinical Note
March 2013

Battery Ingestion Leading to Bilateral Vocal Cord Paresis

Author Affiliations

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle (Drs Patel and Hillel); and Department of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle (Dr Perkins).

JAMA Otolaryngol Head Neck Surg. 2013;139(3):304-306. doi:10.1001/jamaoto.2013.1825

Importance Disk battery ingestion is common in the pediatric population, with over 50 000 ingestions reported annually. In the upper aerodigestive tract, consequences of such ingestions vary widely from superficial mucosal ulcerations to death from erosion through vital structures. This report describes a battery ingestion complication, vocal cord paralysis, to our knowledge not previously described in the otolaryngology literature.

Observations We describe a patient who presented with biphasic stridor and drooling after upper esophageal disk battery ingestion. The battery was removed 5 hours after ingestion, but stridor with respiratory distress persisted. To stabilize the airway, a tracheotomy was performed after a several-week period of inpatient observation. Two years after ingestion, the patient is tracheostomy dependent.

Conclusions and Relevance Disk battery ingestion has the potential for recurrent laryngeal nerve damage and vocal cord paralysis. Expeditious battery removal and long-term care are crucial for successful ingestion management, as ingestion complications can be significant.