hi everybody my name is Rhŷs Barber I'm
the audiologist here at audiology
associates we upload new ear wax removal
videos every Monday Wednesday and Friday
at 9 p.m. UK time so please consider
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hi everybody this is Rhŷs from
audiology associates thank you very much
for watching our ear wax removal
video today so as you can see in this
patient's here here we've got some very
very dry ear wax now this patient is a
regular patient of ours they come
through but every sort of three to four
months to have this done the ear wax they
form is always very very dry in forms in
plates as we can see here so because
it's quite a thin angular plate I'm
using the crocodile forceps to get a
grip on this section to take this away
first the reason being is when we use
suction we can't get a grip on the ear wax
because it's so angular so if we use the
the crocodile forceps it helps to pull
this out now a patient suffers a lot
with dry skin in the rear canals I'm the
difficulty when you have dry skins it
tends to dry that ear wax out a lot so
that's where you get these harder pieces
here you will see lots of little flakes
of dry skin it's almost like like a
psoriasis or an x-ray in the ear canal
would show up like a very dry type of
expert so I'm you can see go good grip
here on the second piece just taking
that out there that came away nicely we
can see now we've got much much deeper
drier sections it always tends to form
in this particular patients ear canals
there's lots of different sections
layered one over the top of the other so
I'm just trying to get rid of some of
this drier skin you can see that start
to flake away here at the entrance and
then as we get a grip on this side
section then just trying to detach that
from the ear canal wall when it does dry on
the ear canal walls as it does here then
what you'll see is that it really really
sticks to that ear canal wall it really kind
of really here's to it
so just pulling that section there and
we've lifted that you can see it's quite
a long section there trying to hold on
to it with the standard size on the tube
here but can't quite get a grip so we're
going to bring the crocodile forceps
into play again and just going to grip
you can see it's a slightly softer
texture there at the top so some pieces
a little bit drier than others I'll get
a good grip on that you can see that
piece coming it's quite a long section
look at that coming out the ear canal
there and then we rise that deeper
section was attached to it so you can
see those drier pieces in the center
which are the sort of darkest
actions they're in little lighter
sections around the outside which are
the sort of more the dry skin pieces
around the outside they're just going to
take away some of these some of these
little dry skin pieces with long strips
like that it tends to whistle a bit when
you get hold it with suction so it
doesn't come always straight away I tend
to go in and use the the crocodile
forceps then to detach it because of the
type of condition this this this patient
has you're not gonna be able to remove
all this dry skin from in there
unfortunately that is just going to keep
forming all the time so we're just going
to get a grip on this top section here
we're just taking that away now just
lifting that off the ear canal it's coming
away there we go so has to attach them
with a dry skin with it there as well
and you've got these harder ear wax pieces
and this one here to the left hand so
you can see how well attached that is to
the ear canal wall just taking that away you
got that ring of dry skin in there as
well the difficulty with this especially
this type of dry skin and I know from
past experience with this patient if we
start peeling this along the skin is so
dry it does tend to just tear that this
almost the top layer of skin so you do
sometimes get a little bit of bleeding
with these so what I've done I've
elected to leave most of these little
flakes of dry skin in here because it's
just going to run the risk of infection
and everything else and obviously with
the current climate with people not be
able to get to the to their GPS as well
as they normally would beat we decided
we'd leave a lot of this dry skin for
this time but we've gotten these larger
pieces of ear wax away here there we go
you can see just how firmly that's
attached look to the ear canal walls
so rather than peel it upwards what I'm
going to do is use the Jobson horn and
just bring that along the top of this
dry skin and what that will do is
instead of lifting it and causing a
tearing action against the skin it's
actually dragging on
surface was bringing it along and down
with the direction of skin flow if you
like so as the skin migrates to the
outer part of the ear canal it's a bit
like working with the grain if you like
of the skin rather than against it that
kind of thing so just getting some of
these looser littler pieces of ear wax away
there we go and this little dry piece
here at the top which is upload our
camera just a second ago now we can see
now that when you look a bit further in
you've got little tiny pieces of hard
ear wax much much for them very close to the
eardrum tucked into that valley
so we're gonna be really careful here
just to get a grip there we are you can
see what initially looked as a very
small piece of ear wax there's actually
quite a large chunk set down there next
to the ear drum and if we look again
we'll see a piece just off to the right
hand side there that we can see so we're
just going to try a name of this and we
talk about this valley in front of the
ear drum quite a bit now you can see
that you can only just about see the
leading edge which makes it a difficult
place to take it away from we've got the
fine end on here which is going to be
helpful you can see a little bit just
flicked up against the the suction there
so we've just got that little piece away
but there is another piece of bit
further in so we're aiming you can just
about see it there so it's very delicate
we're trying not to press too hard
against the ear canal wall trying not to
touch the eardrum so work in a very very
tiny space there we go there's that
piece you saw it flick up towards the
camera this you can see you can get
quite large pieces down inside that
valley they maybe aren't sticking
together your drum that ear drum looks
nice and healthy now it's good so we're
gonna move on to the second ear now so
you can see a very similar issue here on
the second yeah lots of ear wax just inside
the just inside the ear canal so we're going
to use the crocodile forceps again for
this one get a grip on this and get a
piece of the front section here and
using gentle but steady pressure just to
take this out very very slowly just a
trained avoid any tearing or breaking of
the ear wax there we are at came away nicely
you can see that nice piece there and
then we can
see we got a little bit of a gap there
at the top a little bit of dry skin as
well at the top of that ear canal and
all on the sides there so we're gonna
use the st. Bart's hook now just to come
in and get behind this piece of ear wax I'm
looking to aim there now can you see the
first time with him we just touched the
back end of the ear wax it didn't we
couldn't get the full turn to the st.
bar top price we weren't a little tiny
bit further ad we got that falter and
shows me behind the ear wax there and we'll
just use this now just a maneuver this
last section away yeah we are just
slowly pulling this down the ear canal so
we're using the st. Bart's hooky just to
roll this dry section of ear wax down you
can see we just it's really straight
it's attached to the dry skin as well
there so that's come away in one nice
big chunk yeah she got stuck a little
piece stuck that in the bowl of the ear
so we'll just lift that bit up with a
bit of suction oh yeah if we take a look
behind that you can see we've taken the
majority of that ear wax away we've got this
drier skin debris here so this is bits
quite loose a little bit I'll take this
off quite easily there we are that's a
lot better
and then if we go behind that now we can
get to this next section just slowly
peeling this little bits down you can
see quite just know just how hard that
that ear waxes and how well it's attached to
the top of the ear canal there just trying
to get some of these loose bits of ear wax
debris away there we go and see that
one's starting to peel a little bit more
across the top there
see these little looser dry skin section
there we go starting to peel away a
little bit more there now and if we take
a look at the eardrum usually looks good
so we're just going to do the same trick
again there with the Jobson horn we're
just gonna be able to pull along this
section now no the reason I haven't done
that with a deeper section it's
difficult to get behind out this
ultra-sensitive down there and that
that's our inner third of the ear canal
so when you're pressing down on that
with the jabs and all it's really quite
uncomfortable and the last thing we want
is for the patient to to sort of flinch
or for us to sort of drag this along and
causing the bleeding in there so we're
just gonna take these few little looser
bits of dry skin away just getting that
bottom section just trying to pull that
out as well there you go you can see a
little bit we're working on there just
to get rid of that at the entrance there
and the last little bit there just to
get rid of that looser section though
it's difficult to clean the top which
you'll see now chops it straight if I've
got to put pressure on it with the angle
of the Jobson horn we're trying our best
here just to get rid of those bits and
break those away so we see the eardrum
there brother could like reflux there as
well so this is what we removed so we've
got bang on two inches there and or just
under five centimeters if we use a
little bit of dry skin as well well as
always guys take care and I shall see
you on Friday
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