A series of cases involving button batteries lodged in the ear or nasal cavity is presented. All produced tissue destruction. Injuries were generally severe, and included tympanic membrane perforation (three patients) or total destruction (three), marked necrosis of dermis of the external ear canal with exposed bone (seven), documented further impairment of hearing (three), destruction of ossicles (two), facial nerve paralysis and chondritis (one), nasal septal perforation (one), and superficial burns of nasal mucosa (one). Otic and nasal drops must be withheld as they provide an external electrolyte bath for the battery, enhancing leakage and generation of an external current, with subsequent tissue electrolysis and hydroxide formation. Instead, batteries lodged in the ear or nose must be removed promptly.
(JAMA 1986;255:1470-1472)