hi everybody this is rhys barber from
audiology associates thanks very much
for watching our ear wax removal video today
so this patient came through with a
really stubborn piece of ear wax now
i'll just go through this
initial section i'll explain why so the
patient here's got this
quite narrow entrance to the ear canal
very soft ear wax here at the entrance which
you can see us using the standard size
Zoellner tube here just to suck a lot of
this soft earwax you can see a bit
getting sucked into the machine there
but the difficulty here is that this
ear wax has actually become almost
encased in a little bit of dry skin
and there's also some dry skin pieces
interwoven into it now coupled with that
is this patient has
quite a pronounced bend in the ear
canal so we all have bends in our ear
canals we have our first and the second
bend
so basically it bends one way and
then bends back on itself now this
patient's first bend is quite pronounced
so it means that
when the ear wax is forming it's forming
almost on a bend and it's got these
pieces of dry skin
interwoven into it now you can see it
looks quite dark in here at the moment
because there's a lot of old
more sticky ear wax around the entrance to
the canal so when we're shining the
light in from the endoscope a lot of our
lights get absorbed into that ear wax which
is why it looks quite dark to start with
so what we're doing here is just
loosening up the sides and you'll start
to see here these little bits of skin
now you can see that long strip that
came away at the top here
now you're really conscious with these
longer strips of skin because when they
get sucked into the end of the suction
tube
what can happen is they can vibrate up
and down really quickly
which is something they call clarineting
which gives a very high pitch quite a
loud shrill whistle in the ear when that
happens
so what i'm trying to do here is avoid
that top section of skin
and move to the
bottom bringing it down slightly so that
we can
get a lot of that skin and ear wax into the
end of the suction at the same time
which stops that from happening
the difficulty here is that skin is
really still firmly attached to the ear
canal
so we're using the crocodile forceps
here not so much to try
and take this blockage out because a lot
of people in the comments
say crocodile forceps aren't
particularly effective you don't seem to
get a lot out
but in this case we're not using them to
try and remove the ear wax what we're doing
here
is trying to take the pieces of skin out
of that ear wax plug
so we've got a better chance with
the suction as we are here
to try and draw the ear wax itself down the
canal and then we can
move those little bits of skin there
interwoven in there that start
popping out as we take more of the ear wax
away into a better position to get the
forceps to remove those next
sections so it's a case of unpicking and
sort of teasing those little bits of ear wax
out here
so you can see now we've got these bits
of skin popping towards the front
so we'll just clamp onto that then with
the crocodile forceps and bring this
forward
same again here there we are
you can see these very fine little
layers of skin that have formed in here
now i know a lot of you are going to
ask me in the question in the comments
section below
why do you get these kind of bits of
skin forming in the ear wax well because the
ear canal can sometimes dry out a little
bit you can get these lifts of skin off
the canal
and then the ear wax because it's been here
a little while has folded around it
now this gent was actually a really
really lovely guy and his
son is getting married on the weekends
he was desperate to hear better ready
for the wedding
so we did manage to clear out
today as well but you can see now you've
got these little bits of
dry skin coming down from the top of the
canal you've got them coming in from the
left and the right
and they're covering over that block of
ear wax so basically where it's
all peeled and folded with the
suction
it's all sitting over that plug
there so we're still going to have to
keep using the forceps for the time
being
and gently pulling those bits of skin
away just to allow us to get to the next
piece of ear wax in here
there we are you can see that edge as we
pull down you can see the
whole edge just starting to lift there
and that's this one
long piece of dark and dry skin and ear wax
mixed together here
you get a better view of it
we pull down from that side
then you can actually see the whole side
lifting away
watch it now here you'll see the same
thing again you can see it
there
and that's this layer of dry skin
running down the one side of the ear wax
here
and folding over in front
of it
we have a good grip there on a
nice piece of skin
further in now we're starting to see a
little bit of skin here at the top you
can see its a little bit brighter
as we're starting to uncover the
ear canal walls a little bit more
and as we're pulling the skin because
this it is a little bit
softer it's not quite hardened up
Its a little bit wet as well a
little bit of
softness to it so as we're clamping with
the forceps it's actually
tearing bits off it rather than
pulling the whole chunk out in one go
were trying now to to move to
this bottom section
i'm trying to bring all the ear wax and skin
into the end of the suction tube so we
can get a really good grip here and
start
really wiggling this around but you can
see it's just loosened another little
piece of skin here at the top let's get
rid of that
we've got a bit of turbo wiggling coming
up in a second guys
it took a lot of wiggling to get this
out so we're still pulling
these bits of skin away
we're starting to tease the edges
away
i'm trying to lift from the bottom to
see if we get the whole thing in one go
we can see all the skin is really
lifting up now
we've got a good grip on this now
with the suction tube trying to hold it
all in there to stop that clarineting
that high-pitched squeaky whistle
there we are you saw a big chunk of that
skin getting sucked in now
so we've got rid of all the looser bits
around the outside edge let's see if we
can work on this
main plug now get this patient hearing
better so we can enjoy their son's
wedding
so you can see it's
lifting
it's starting to move forward we're
starting to see the plug just
creeping down the canal a little bit
we've got a good grip there
a little bit of a wiggle let's see if we
can reposition this
unfortunately what happened as we've
pulled down on the ear wax
this layer of skin that's come
over and its
rolled in front of it here as
well and it's held on
further behind the ear wax so we're going to
bring the jobson horn in here i just
want to see if we can get behind
and break that adhesion but watch what
happens as we push
down that's the layer of skin basically
it's just slid over that layer of skin
unfortunately for us the jobson horne
actually caused more problems it's
actually pushed it further down on top
of the ear wax
so now we're gonna have to go back in
with the suction
and lift that whole section we've just
pressed down if we were lucky the jobson
Horne would have just got behind that
bit of skin and drawn the whole thing
forwards
but unfortunately it pushed
it down on top of the block
but we've got a good grip here
starting off with a bit of gentle
wiggling here let's see if we can work
this down
that's just not budging okay let's pop a
little bit of olive oil in here then
let's loosen the edges around here
To give us the best chance let's see if we
can slide this across the skin if we can
get a bit of movement
we may be able to slide it out so we've
got a good grip here olive oil is going to
help us to get a really
tough good suction grip on this skin as
well
and now we're going to hold on to this
there we go you can see we're starting
to increase the wiggle now
turbo wiggling about to engage
we are really wiggling
this spot pulling down from the top
teasing this forward you can see it's
working it's way out here
a long strip of skin again let's get rid of that
so we don't start clarineting
here
let's get a pinch on that long strip
that's just popped out from the main
block of ear wax there we go
let's get rid of that bit of skin now we
can go back in without the risk of it
squeaking
and we're going to really hold on to
this section
there now you can see all that skin that
grey material flicking up here
we've got a good grip we're really
getting the wiggle going here now we've
really wiggling back and forth
drawing this down the canal we've got it
out with a little bit of circular movement
there we go and out it comes you can
see that grey skin underneath the big block
of ear wax there lovely big chunky bit
and it was sitting right on the corner
so let's go behind that now we'll get to
the next section
now we've loosened that initial piece
everything else now that was
bound to it and hanging on to it is
going to have broken those bits apart
and we're just going to start to get
this coming away a lot nicer now
there we go next section coming away
nice big chunky piece of ear wax as well
there
and even more behind that now so let's
get a good grip on this next section you
can see
how much easier it is now to remove
these last few pieces here
now we've got that initial section away
but you can see just how deep this ear wax
had gone so no wonder this
lovely gent was really struggling with
this hearing
let's just tidy up this top here have a
sneak around the corner you can see how
much of a bend there is we've got to
kind of bend the endoscope
around the corner to get a good look at
the eardrum somebody asked if we could
just pause on the eardrum a little bit
longer so you can see
here that you can see the brown
splodges on the eardrum there now
basically that's where the ear wax had
actually gone down as far as the eardrum
so you can see how
difficult it would have been for this
patient to hear
so we've got three and a half
centimeters
what's that two and a half centimeters i
can't remember
i'm going to say i'm looking at it from
the top an inch and a quarter there i
think
yeah but three just over three
centimeters three to three and a half
centimeters
so quite a bit and that just came out of
one ear canal but the patient
so grateful they could hear so much
better ready for their wedding
oh guys one thing i did say for
announcements at the end but i forgot to
because i was going to announce one mr b
senior gyms have now reopened
in wales mr b senior is going to do his
30 ton challenge
on wednesday so i'm going to record that
wednesday evening i'll put a video
together and i'll put it on that on the
channel but just so you know he's
attempting that on wednesday
so i'll keep you posted about that one
as well let you know how we get on with
that one if you have no idea what i'm
talking about
i'll put a card up there so you can see
you know what my dad's attempting
on wednesday for charity so guys thanks
very much for watching i hope you
enjoyed the video as much as i did
voicing it over
and i shall see you again on wednesday
as always guys take care of your ears
take care of yourselves and take care
one another and i'll see you again real
soon take care everyone