A Budding Problem: A 20-Year National Analysis of Pediatric Earbud Injuries

Introduction: While pediatric ear foreign bodies are well described, injuries related to headphone earbud use have not been reported. As earbuds (and especially wireless ones) continue to increase in popularity, understanding the risks associated with earbud use becomes increasingly important. Methods: We conducted a retrospective review of earbud-related injuries in patients ≤21 y using the National Electronic Injury Surveillance System from January 1, 2005, to December 31, 2024. Cases were identified with keyword search terms. Manual review of narratives was used to identify presenting complaints and associated symptoms. Results: We identified 784 earbud-related cases, representing a national estimate of approximately 27,893 cases. Interestingly, cases increased significantly over time (4.2 cases/year; R² = 0.85; P < 0.001). Ninety-eight percent of children were treated in the emergency department and discharged home. The most common presenting complaint was ear foreign body (61%), followed by nasal foreign body (13%) and swallowed foreign body (8%). Age-related differences were significant for both involved anatomical site and mechanism of injury (P < 0.001). Younger children (≤7) were more likely to swallow earbuds or insert them into the nose, while older children were more likely to sustain injuries from inserting them into the ear. Conclusions: Earbud-related injuries in children have increased significantly over the last 20 y. Younger children are more likely to ingest earbuds or insert them into their noses, whereas older children are more likely to experience ear injuries. These findings may reduce preventable harm through improved product design, age-specific safety precautions, and expanded education.