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Objective <p>This study aimed to characterize pediatric nasal button battery impactions and evaluate, in an in vitro septum model, the efficacy of household reagents in mitigating alkaline-induced injury.</p> Methods <p>We retrospectively reviewed 230 pediatric cases over ten years. Demographic characteristics, presentation times, and complications were recorded. In vitro, sheep septal cartilage segments (2–3&#xa0;mm thick) were immersed in saline at 36&#xa0;°C and exposed to a 3&#xa0;V button battery for 15, 30, 45, or 60&#xa0;min to determine the critical injury window. In the 30&#xa0;min group, interventions with honey, MOH (a honey–olive oil mixture), vinegar, vitamin D, glycerin, and saline were applied, and the tissue pH, residual battery voltage, and injury depth were measured.</p> Results <p>A retrospective analysis of 230 children revealed that 61.7% were male, 97.8% were aged 1–5&#xa0;years, and 87.4% presented within 24&#xa0;h of battery impaction; the incidence of nasal septal perforation was 16.5%. In vitro experiments identified 30&#xa0;min as the critical window for rapid tissue injury progression, with a mean injury depth of 2160 ± 43.8&#xa0;μm. Intervention assays demonstrated that honey (685.3 ± 92.2&#xa0;μm), MOH (1038 ± 145.1&#xa0;μm), and glycerin (1275 ± 39.6&#xa0;μm) significantly reduced injury depth without breaching the perichondrial layer. Honey and MOH best neutralized the pH, whereas glycerin and vitamin D inhibited battery discharge the most. Saline, vinegar, or vitamin D alone had no protective effect on depth.</p> Conclusion <p>Alkaline burns from nasal button batteries progress rapidly within 30&#xa0;min. Household reagents—especially honey, MOH, or glycerin—neutralize pH, inhibit discharge, and attenuate tissue damage. In prehospital settings where immediate care is delayed, early application of honey, MOH, or glycerin is recommended to minimize severe complications.</p>

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Pediatric nasal button battery injuries: a 10-year retrospective study and in vitro evaluation of prehospital mitigation strategies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月25日

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  • Lai Xueyou,
  • Huang Zhenhui,
  • Jia Desheng,
  • Li Zenan,
  • Wang Xin,
  • Chen Yongchao,
  • Pan Hongguang,
  • Zeng Nan,
  • Yan Shang

摘要

Objective

This study aimed to characterize pediatric nasal button battery impactions and evaluate, in an in vitro septum model, the efficacy of household reagents in mitigating alkaline-induced injury.

Methods

We retrospectively reviewed 230 pediatric cases over ten years. Demographic characteristics, presentation times, and complications were recorded. In vitro, sheep septal cartilage segments (2–3 mm thick) were immersed in saline at 36 °C and exposed to a 3 V button battery for 15, 30, 45, or 60 min to determine the critical injury window. In the 30 min group, interventions with honey, MOH (a honey–olive oil mixture), vinegar, vitamin D, glycerin, and saline were applied, and the tissue pH, residual battery voltage, and injury depth were measured.

Results

A retrospective analysis of 230 children revealed that 61.7% were male, 97.8% were aged 1–5 years, and 87.4% presented within 24 h of battery impaction; the incidence of nasal septal perforation was 16.5%. In vitro experiments identified 30 min as the critical window for rapid tissue injury progression, with a mean injury depth of 2160 ± 43.8 μm. Intervention assays demonstrated that honey (685.3 ± 92.2 μm), MOH (1038 ± 145.1 μm), and glycerin (1275 ± 39.6 μm) significantly reduced injury depth without breaching the perichondrial layer. Honey and MOH best neutralized the pH, whereas glycerin and vitamin D inhibited battery discharge the most. Saline, vinegar, or vitamin D alone had no protective effect on depth.

Conclusion

Alkaline burns from nasal button batteries progress rapidly within 30 min. Household reagents—especially honey, MOH, or glycerin—neutralize pH, inhibit discharge, and attenuate tissue damage. In prehospital settings where immediate care is delayed, early application of honey, MOH, or glycerin is recommended to minimize severe complications.