hi everybody this is rhys barber from
audiology associates thanks very much
for watching our ear wax removal video
today
so we're going to talk you through
a patient that came through the clinic
yesterday they've got a very thick and
sticky type ear wax
so we're going to be using a little bit
of micro suctioning here today and also
the jobson Horne is going to make an
appearance as well
so without further ado we'll go straight
into the video so what you can see here
the patients come in feeling very
blocked up in both ears you can see this
this very sticky tacky type ear wax that
we refer to this a lot as almost a clay
type ear wax so imagine play-doh
or sort of dough consistency
basically in this ear canal
with a very sticky outside layer now
this patient has to have their ears
cleaned out every few months
they work in a job that's very dusty
so there's a lot of fine dust in the air
and i think that's contributing towards
this ear wax drying slightly because it can
draw some of the oils out of this as
well
so what you can see here we've got the
standard size zoellner tube in here
and we're just taking this ear wax away from
the outside edge first of all
just slowly lifting and teasing this
harder piece on the outside edge it is
quite sticky but it's also a little bit
harder on the outside edge here
we get to the very very tacky ear wax a bit
further in now
but what you can see is as we're lifting
from the base of the canal it's actually
taking some little bits of dry skin away
as well
now if you just remember i said this
patient worked a lot of fine dust
now it does tend to draw a lot of the
oil or absorb a lot of the oil in the
ear canal
so you will get these little bits of dry
skin and this more kind of tacky
sticky clay type ear wax coming away here
so what you can see now we've got a good
grip on the top of this
it's just slowly working its way down
the canal
just trying to wiggle this out
because as we're pulling this out it
wants to stick back to the ear canal
walls
now sometimes we can pop a little bit of
olive oil in here just to counteract
that a bit
but the ear wax is moving quite well
we're just going to carry on
as we are very slowly working this
down
you can see the movements i'm using here
which is just this kind of very fine
movement to the one side
you're almost grabbing hold of the ear wax
picking it up moving it back and then
dropping it back into place
so you kind of very slowly we call it
kind of walking it down the ear canal
here in the uk if you've got a big
object you're trying to get into a fine
gap you kind of shimmy it back and forth
that's the sort of thing we're trying to
do with the ear wax here as well so
it's coming towards the outside edge of
the ear canals a nice big block i'm
trying to keep it in one piece
if we can it's not always possible with
this type of ear wax
just detaching it now from this left
side canal wall
and there you can see there's a little
bit more movement to the ear wax now it's
just starting to free up a little bit
unfortunately that piece just broke away
so we're switching now back to the right
side
now we've created a little bit of a gap
on the left we can manoeuvre it now
into that gap and then start bringing it
down
very thick material this
we've got a good grip there you can see
we've managed to drop the suction tube
directly on top of the ear wax
so it's completely covered the end of
the the zoellner tube here
we've got it so far but it has got a
little bit stuck so the jobson horn is
going to come in now
somebody asked me in the comments why
does the jobson horn have a hole in it
so you can see through it so you can see
where you're going
but this is a great little device just
to be taken on the outer part of the ear
canal
you can see it's a little bit cr bly
almost just behind
we have something called tablet here
in the uk it's a bit like fudge but
cr bly fudge so that kind of
consistency
so it started to come away we've got a
good chunk there just lifting up so you
can see it
very dark in colour so it's oxidised
quite a bit already
and you can see it's left behind this
little bit of a remnant this
layer at the base of the canal here so
as we lift this up this is where you
start to see a little bit more that dry
skin lifting with it we've got a good
grip there we're going to slow this down
so you can see it coming out
there we are and then when we get behind
that
this discolouration you can see here to
the left hand side
that's very fine layer of oil
and
stickier ear wax debris basically it's
really uncomfortable to remove sometimes
because you have to
press quite firmly against the canal
wall to get this out but there is this
thicker stickier blob here on the roof
of the canal so we're just going to work
our way up to that one
and we'll come back to that little bit
at the entrance in a second
you can see just how as as this peels
away from the canal wall
just how sticky that is so it's really
kind of having to pull on this to draw
it down
we've got that away now so we're going
to use the technique where we go
past what we're actually trying to
remove and then draw the suction tube
back along it
and we're doing that repeatedly then
just to take the surface layer off
and as best we can trying not to touch
the canal walls we don't want to dig
in there and drag it along because that
would be really uncomfortable for the
patient
good looking eardr here you can see it
looks lovely and healthy hammer bone
pointing up to the right side
to the yeah to the right side though was
it so however i'm putting up to the
right
hand side second ear now so the
patient's other ear very similar issue
here as well
now the ear wax on this side looks a little
bit drier here at the entrance you can
see
as we get a grip we're trying to move it
but you notice the whole block doesn't
move
the piece you're attached to bends and
flexes there
but it doesn't come away completely so
we're just
moving this and manoeuvring it out it's
a chunkier piece so there's not a great
deal of room to manoeuvre in here
so here we go we're just going to go in
now with the Jobson Horne ideal for
getting behind the ear wax ideal for a
jobson horn it's slightly angled
imagine this is a block of ear wax you're
going over the top and then drawing down
and forwards which is what we're doing
here very slowly pulling this out
very thick sticky material here though
there we are that's that first piece
gone now you can
see how it's coated all along the bottom
of the canal here this
very thick layer now with the
jobson horn
because you rely on the fact you have to
press behind the ear wax not ideal for
taking it off the canal wall like this
because you're pressing down you can't
see where the ear canal wall is so
you're pushing against it and can be
really uncomfortable
so i've opted to go back to the suction
tube the reason being we can
lift from the base of the canal and just
start lifting this up and drawing it
down it's a lot nicer for the patient to
have it removed this way
so you can see we're working our way
down you will see a little bit of that
dry skin it's a lighter material if you
just look at where the
suction tube is you'll see this
lighter material lifting up which
seems to be just in front of the ear wax
that's a layer of dry skin coming away
here as well
just getting these thicker chunkier bits
out
well guys don't forget we post new
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video then please consider subscribing
we've got this very dry
thin layer here that's connected to a
bit of dry skin we've popped a bit of
olive oil in here to get
this last bit loosened there we go out
it comes so we've managed to get rid of
that last little piece we're just going
to draw this down the canal
get it to the outside edge you can see a
very smooth surface to that ear wax where
it's been sitting against the canal wall
and kind of moulded to that shape
ear dr is looking lovely and
healthy there's a little couple of
little loose bits here
on the left hand side we'll just tidy
those up a little bit of much darker
material there stuck to the actual roof
of the canal as well
so we're just gonna zip around those
hoover those bits up
there we are you can see how dry that is
it's peeling away in these
long chunks now the one bit of advice
that this patient hadn't been given in
the past was to use a bit of olive oil
as a preventer
it's really good when you get this kind
of stickier type ear wax so if you're
working a job there's a lot of dusty
environment there
putting a bit of olive oil on a regular
basis about once a month we'll just keep
everything soft and keep it moving
so you can see this is what we removed
here well some of what we removed
some ended up in the tank
so we've got two and a half centimeters
just over an inch there between both
ears a lot of the smaller bits of debris
did get sucked inside the tank as well
so all looking
nice and
sort of sticky it's really dark this
materials really oxidised well
well guys i hope you enjoyed that video
as much as i did voicing it over i do
have an announcement though obviously
you know we're looking for another
audiologist here at audiology associates
because i am
super busy and i'm really not getting
much time to edit these videos
but i'm also going on some leave so i'm
actually away next week so realistically
i think you may go
almost a fortnight without your videos
don't panic there is a long back catalog
of videos you can go back through guys
but yeah i bear with me i don't get
back to it until
a week on tuesday so it might take me
a couple of days to get back into things
and
get some edits done but as always
guys look after yourself so take care of
your ears take care of yourselves and
take care of one another
i'll see you in a couple of weeks have a
good few weeks without me guys take care