hi everybody my name is Rhys 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
subscribing hi everybody this is Rhys
barber from audiology associates thank
you very much watch my ear wax
compilation video today there's two
patients in this compilation I just
wanted to show you the difference that
with these two patients came into clinic
back-to-back
so this first patients come in once I
did here in loss affected more when they
sleep at night because when they wake up
in the morning the ear wax is squished
together you can see that we've got
quite a large piece of ear wax here at the
entrance to the ear canal a little bit of
little white stuff you can see this is a
bit of dry skin so we just got a good
grip on that with the standard size on
the tube and just manoeuvring that out
of the ear canal there you go and it came
away really nicely in one piece a little
bit of irritation to the top right
corner of the ear canal there where they've
been trying to get in there with a bit
of a cotton bud so you can see all came
out in one go so this is the second
patient the compilation so this patient
came through very dry that ear wax actually
in both sides was having a little bit of
difficulty hearing aid wasn't working
very well so came in to see us to check
the ears so what we're going to do
first of all is remove the ear wax from the
ear canal wall as best we can because what
you could see was a central depression
in the ear wax which is usually a good
indication the patients use some cotton
buds just to try and clear the ear so
you're a lot of the time then you end up
with this kind of thinner hard a layer
of ear wax around the outside going into a
central a big chunk or wall of ear wax where
it's been polished into a war with a
slight depression in the centre so not
the easiest of ear wax to remove especially
when it's this hard and we've got a lot
of dry skin in this ear canal as well
so that's going to dry the ear wax even
further so what you tend to find with
this kind of ear wax is it will dry on to
the layer of dry skin underneath which
is what's happened here so I'm just
using the
crocodile forceps if we're really lucky
what happens with this kind of ear wax is it
stays together really well we can get a
leading edge underneath which is what
we've done here and then use the forceps
to bring the whole thing out
unfortunately in this case we weren't
lucky and as we got a grip on the
outside edge of the ear wax here it just
tore a plate that was resting against
the ear canal away you can see that coming
away there so we're just going to go out
under and just see if we can we've got
another leading edge just see if we can
get behind this piece and take this
whole section away but as you can see it
just broke another plate of ear wax over
this you can see the edge of that
depression in the centre now where it
becomes a little bit more complicated
here now is we have a layer of dry skin
that's flicked up from the ear canal wall
which means that we're trying to get a
grip on this piece of ear wax but this dry
skin keeps flicking up in front of the
suction so what we're going to have to
try and do is get rid of this dry skin
first of all go be quite careful here
especially when you're suctioning skin
because it can vibrate in the end of the
suction tube causing a really shrill
high-pitched whistle so I'm just
manoeuvring it see if we can get away
easily and then using the crocodile
forceps to minimise any noise in the ear
ear canal then but you can see this layer is
quite long and it stops or it's actually
tucked underneath a piece of ear wax we need
to get to so it you can see it's really
frustrating every time you put the
suction in the skin flicks up and stops
from getting to what I need to which is
that edge of the ear wax the ear wax itself as
well as as formed perfectly to the shape
of the ear canal so it's formed a plate
and the leading edge I know is there is
to the top right hand corner behind that
triangular skin you can see hanging down
so I can't get to it as much as I try to
that you can see the skin gets in the
way and I just can't get to that leading
edge underneath because the skin has
come down and it's quite a wide into
white quite a wide base there
I can't get the crocodile forceps on
either side of it to grab it to take it
away as you can see it's because the
skin is just bumping the bottom edge of
the 4-step up I can't get underneath it
underneath that piece of ear wax behind it
so quite a frustrating removal this one
because you can see what you need to get
to and you can see how you can get it
out but you've got to do a lot more work
before you can actually get to that
point so you got to clear that and skin
is especially tough dry skin like this
is a a bit of a nightmare to remove
so what we're doing is switch into a
fine end now so I'm trying to reduce the
amount of whistling the patient will
experience in the ear canal whilst we're
taking this away due to the ear wax very
braiding through you can said this is
the section we need to work on but as
I'm pulling it you can see it's just
pulling more dry skin down so I'm trying
to break this layer some way without
pulling it to Fox I don't want to cause
any bleeding or anything in the ear
ear canal as well so I'm trying to manoeuvre
this out of the way I think what you've
got a visualise in your head is that
this space looks huge on here but
we're talking this space is need about a
centimetre across so you're trying to
make very fine movements trying not to
touch the ear canal wall and try to get this
what this skin away without tearing it
too much and get to the ear wax behind it so
then now we can see that edge that's
what I was aiming for I just want to
pull it down into the centre of the
ear canal a little bit more because that's
going to make it easier to get the force
out by there okay so now we've got a
good edge to work on that's far enough
away from the ear canal wall that we're not
going to press into the ear canal wall or
scraping against the ear canal wall
here we are unfortunately there's more
wipes behind that it didn't come out in
one big chunk so we need to get a grip
on this on this deeper section of ear wax
now but we've got quite an angular piece
to it so I have to weigh them quite low
on the ear wax to try and get to the
smoother flatter section and
unfortunately that's exactly where the
skin is so once again the stray scale is
just impeding the piece we need to get
to in order to get this out so just use
the crocodile forceps just to get a grip
on it and sometimes you're lucky and the
whole thing will peel away in quite a
big plate and you'll get to the ear wax
behind it but this skin just did not
want to play ball today it was tearing
into awkward angles and just in all the
wrong places
so just didn't did not want to help me
out to get this ear wax over here at all we
are just trying to peel some of the
leading edge away there you can see it
ends up with these kind of strands
can't get behind it with a forceps
it's just pressing and pushing that ear wax
further in you can see this massive
layer of dry skin that's in there it's
really difficult to remove that you
imagine the skin is attached to the
layer underneath so you can't just go in
and just rip it out you've got to kind
of go in and manoeuvre it around and bend
it and try and kind of tear it off into
a larger piece if you can if you can see
just know for straightness is because
the more you're taking away the more
you're lifting up off the layer
underneath you end it when as you take a
piece of way you end up with a bigger
piece then which is what we've got here
and this ear wax is so dry that we're
struggling to get a good grip on it you
can see it's moving around quite a bit
as well so it's very loose in here so as
we did with the piece before and trying
to bend it down so we get a good edge I
can get behind it with the forceps there
we are so we're just gonna grab that
with the forceps
there you go so that's one of the deeper
pieces coming away unfortunately there's
another piece behind that one as well so
we've got to show you get this one out
and I've have sprayed a little bit of
olive oil in here but you can see that
the olive oil just didn't get down to
that base section of ear wax although the
patient had their head tilted over for a
while it just hasn't got down there and
that layer of skin at the bottom is
stopping the oil from getting down to
the edge of this ear wax we would put oil on
the drier pieces like this it'll help us
get a better grip on that ear wax there but
as you can see what about the tearing
away the awkward angles rather than
coming away in one big sheet it's just
coming away in a small section but we
can now get to the ear wax behind it always
more difficult when it's this solid
shape of the ear canal we're lucky that it's
not too thick this piece so we can turn
it so then we can get that leading edge
for the crocodile forceps again or
almost got it there you go you can see
it you do get these ear wax from before
sometimes which is nothing goes to plan
do you think I've got a really good grip
it's all going to quit in one piece and
then stuff like this happens it breaks
away the grip you get on it is it's not
big enough food you get the force up
properly onto it so we're going to go
back to it with a suction now we've got
it to the outer part of the ear canal
we're gonna see if we can suction all
over the rest of the weight here we are
look a little bit left behind so we'll
get that as well here we go
so there's your drum and you can see a
couple of little air bubbles there to
the bottom left hand corner of the ear
drum so a little bit of middle ear fluid
there this patient also had very dry ear wax
on the other ear so we're gonna do that
one as well now so you can see a little
bit different they're so much lighter
in colour it seems to be lots of layers
or lots of pieces close together so not
the kind of solid piece perfectly form
to the ear canal on this side just lots of
little pieces all together so just
taking this
bottom section away first can see a
little gap to the left-hand side they're
just buying the piece we're working on
now so it's just going to be a case of
unpicking this piece by piece got a much
harder section here at the top
I think this top section is connected to
everything else so what we'll do is
we'll clear some of this debris at the
bottom first and then we may be able to
get this piece out in one chunk we just
need to kind of gently pull down you've
got that dry skin issue on this side as
well so this is just complicating things
because it the dry ear wax holds on to any
lift of dry skin so what I mean by that
is any kind of slight peels of dry skin
in here they'll hold on to that and dry
around it so what you end up with is a
hard piece of dry skin that's firmly
attached to the ear canal and a hard piece
of ear wax firmly attached to the skin so we
just it won't budge so there was a gap
so that we'll try that slightly st.
barts hook if it's a thin plate it's
gonna be ideal but unfortunately it's
not a thin plate we can see it goes in
much further and then there's no gap at
the side of that then to get the st.
Bart's hook in behind it to pull it
forward so it's not going to budge so
I'm gonna work on the right site and see
if I can detach this from the ear canal wall
to use forceps with it there we are so
we can just got a gap no left and right
so I can get behind the edge just there
try and get a really good grip there you
go and hope that dark harder chunk comes
now we can start to see the eardrum so
that's great we know we've cleared that
nothing really deeply as it was on the
other side so just a little bit of very
dry ear wax here to the bottom right hand
corner peel the other way got a little
ring of kind of drier flaky a bits of
ear wax on the upside they so we're just
going to tidy this up a little bit what
we don't want to do is you can see it
just starting here is you get these kind
of dry skin poles so I'm just going to
try and break that off there
really want to pull that all the way
down so that this kind of skin pull when
it's very dry that this is so tough you
just keep going and going and going the
goat goes no the majority the way down
the ear canal you've got to remember
that blood vessels in the ear canal walls
are really close to the surface the skin
is paper-thin so if you go pulling long
strips of dry skin off it's just gonna
cause a bleed which is gonna leave you
at risk of infection also not very
comfortable for the patient so we're
just clearing around as much so safely
canna in the outside edge if you're not
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you go so you can see we've got the
eardrum there so this is what removed
you can seal the harder piece of ear wax
they saw us up at six and a half
centimetres there two and a half inches
we bunch it together a bit you very much
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