Mechanism of ear canal button battery injury and strategies for mitigation of damage

OBJECTIVES: In this study, the damage caused by button batteries (BB) trapped in the ear canal (EC) and strategies to reduce this damage before their removal were investigated in vitro. METHODS: After four EC models prepared from freshly frozen cadaveric bovine ears were thawed, 3 V lithium BBs were placed in the channels. After a three-hour period of preliminary damage, nothing was applied to the first EC model, the second EC model underwent saline administration, the third EC model underwent boric acid administration, and the fourth EC model underwent the administration of 3% acetic acid. The voltage, tissue temperature, and pH of the BBs were measured. The BBs were removed at the end of the 24(th) hour, and the EC models were examined by a pathologist. RESULTS: The greatest decrease in pH was detected in the fourth EC model in which acetic acid was administered. The depth of necrosis was 854 μm in the first EC model, 1858 μm in the second EC model, and 639 μm in the third EC model at the end of the 24(th) hour. No necrosis was detected in the fourth EC model. CONCLUSIONS: Lithium BBs can cause alkaline tissue damage in a short time in cadaveric EC models. pH neutralisation strategies appear to be experimentally successful under in vitro conditions.