Syed Nusrat Raza, Shoaib Ahmed, Adnan Saleem Umer, Junaid Alam.
Metallic Discoid Foreign Body - Emerging Complications with Changing Trends.
Pak J Otolaryngol Jan ;30(3):71-4.

OBJECTIVE : To analyze the complications, nature and frequency of disc shaped, metallic impacted foreign body in ENT region and suggest management relevant for each case. STUDY DESIGN: Multi-centric Descriptive study. PLACE AND DURATION OF STUDY: Study was conducted at ENT departments of CMH Multan and Rawalpindi from April 2010 to February 2015. MATERIAL AND METHOD: All patients reporting with round, flat (disc shaped) metallic foreign body anywhere in ENT region were included in the study. The data was analyzed with regards to nature and frequency of different metallic discoid foreign bodies. A comparison of two main discoid metallic foreign bodies i.e. coins and button battery was then made with regards to complications, frequency and nature. RESULTS: A total of 78 cases of metallic discoid foreign body in ENT region were included in the study during the period mentioned. All were children between 1-7 years of age. Out of them 56 cases had coin impaction in oesophagus (5 rupee coin in 22 & 1 rupee coin in 6 cases). During the same period 8 cases of button/disc battery were encountered in the nose, 4 in ear and 10 in oesophagus. The complications with button / disc battery impaction outnumbered those with coin impaction. They included nasal septal perforations, drumhead perforation (both encountered with small button battery only) and oesophageal perforations (encountered only with large button battery). CONCLUSION: Coins are still the most common metallic discoid foreign body encountered in ENT region. They are followed by button/disc battery, which are however much more dangerous with regards to complications. Effort must be made to remove button/disc battery as early as possible, preferably within two hours of ingestion / instillation. If however more than eight hours have elapsed since ingestion of button/disc battery, the possibility of tissue damage and perforation must be borne in mind.

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