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hi everybody this is Rhys Barber from audiology associates thank you very much
for watching our ear wax removal video today this ladies come through with very
blocked up ears in both on both sides really been struggling with her hearing
a little bit of discomfort in here as well caused by the ear wax pressing on the
ear ear canal walls but no other signs or symptoms apart from that one really so
what you can see is that we've got some really tough hard ear wax now this lady's
never had her ears cleaned out before so we've tried using the standard size zoellner
tube but it's just not getting a grip on this ear wax you can see there's
lots of dry flaky bits of skin around the outer entrance to the ear ear canal there
which shows me that this lady suffer a little bit with dry skin so there's
probably not a great deal of oil being produced in this ear ear canal which can
then effectively dry out the ear wax you get a very dry and hardened up ear wax
what's complicating things a little bit is the entrance to the ear ear canal is so
narrow as we get older sometimes the ear ear canal will go from that nice rounded
shape to a much more narrow very thin oval shape and you can see that we're
having a little bit of difficulty getting the the ear ear canal to accommodate
the Jobson horn at the moment we're using the Jobson over the zoellner tube
just because the ear wax is so tough and so hardened up that to use the Zoellner tube
to try and remove the ear wax is going to be difficult it's not gonna get a grip on
there and it's just going to keep brushing against the outer edge so we're
going to use a combination of the Jobson horn to break the ear wax down can see just
how tough that is there's really difficult to get the the Jobson into it
we're going to use the jobs on to break the ear wax down and then tidy up the ear
ear canal there and tidy up the looser sections with the Zoellner tube a bit later
on them so just clearing up some of the outer sections here
just lifting from the bottom the Jobson Horne does a great job because because of
the way it's designed to be used is to go kind of ideally behind the ear wax and
then bring it forward what you tend to do it'll take the top sections away
really easily but it's difficult sometimes to get the bottom sections
lifted off the ear ear canal with it without causing a little bit of discomfort in
there so just probing along the outside edge of this ear wax see if there's a
looser pieces or we can just Hoover up with the Zoellner tube taking away any
loose debris that's there so you can see we're just using the Jobson home we
can't get behind the ear wax so we're just using any leading edge of ear wax any
protrusion of ear wax we're just using the Jobson horn to chip into that at the
moment because there's no gap excuse me I'm sorry
because there's no gap the st. barts hook wouldn't go down the side of this
either there's just not enough gap between the ear wax and the ear ear canal wall
itself so we're just having to chip away at the ear wax here you can see just taking
small pieces away it's really tough old stuff and with the size of the ear ear canal
being as small as it is it's very difficult to get a really good bit of
purchase behind that ear wax to get it down through so just try to chip away at the
top section here a little gap there just trying to open that out okay just you
can see it's not really getting a good a good grip behind that ear wax it's just
chipping the front edge down as it is there like you can't get behind it it's
literally just breaking that that sort of almost like ledge of ear wax at the top
there
you know just tiny tiny pieces coming away
you can see where the Jobson horn is pulling the central sections of ear wax out
but obviously it's leaving the sections stuck to the ear ear canal walls left right you
can see it's just flicking against the side of it look it's not actually
bringing this forward so you've got to push against the side of the ear wax to
bring this out so it's just taking central pieces away leaving the outside
edge sections there which is why we will change tools quite often so this is the
crocodile forceps going in there we're trying to see if we can get a grip on
some of this ear wax because it is quite dry sometimes if you'll get a nice piece
that you can get a good grip on it'll bring a big chunk out with it but it's
quite crumbly and dry so you can see just how harder this when I'm trying to
use the Zollner tube to bring this bottom section of actually off the ear ear canal
wall so we're gonna use the crocodile forceps now we've lifted a little bit of
ear wax at the base there so we're just gonna try use the crocodile forceps to
get underneath it but you can see just how crumbly this is it's this kind of
odd consistency of ear wax it's not strong enough to be able to bring large
sections away but it's also not sort of weak enough in places to be able to pull
out large bits using the section either it's all a case of chipping away and
breaking these smaller pieces away you can see there we've actually get one
larger drier piece but there's a lot more still in here because this this
patient hasn't really been experiencing too many hearing issues until the last
few weeks this has meant that this ear wax has gone completely unnoticed it's
really been plugging the ear ear canal very slowly keeping a small gap in here which
is been allowing the sound through the problem then is you don't really get
this sort of sudden drop in hearing which would which would encourage most
people to come along you can see a little bit of dry skin there as well
this sort of plate or flake of dry skin coming away see there's not enough space
in here really to get a fantastic grip with the crocodile forceps you can see a
little bit more this dry skin at the entrance he yet you know it's got that
flake away
there's a lot of ear wax stuck to the left-hand side ear canal wall here as you're
looking at it here just peeling away with this honor to you slowly working it
off the ear ear canal wall see it all starting to lift away there now
so you're just so firmly that's held in there so we use the Jobson horn now
we've loosened it off the ear ear canal wall just to roll this section out here we go
you can see there's still more in here there better dry skin they're lifting
off the the base of the ear ear canal wall so to help with this kind of thing we get this
dry dryer canals formulas this is slightly harder looking your ear wax you can
use a little bit of olive oil in here on a regular basis which will help to not
only most raise the ear ear canal but it'll help to keep this ear wax a little bit softer
because you can see it how much as this is built up
just using the bottom edge of the forceps to lift this ear wax trim break it
down a little bit at the moment it's formed a solid hard dried lump almost
like a little wall of ear wax in there so taking away some of the looser debris
you see the whole thing is moving in one piece and there's it's the front is
loose but the back is still bound quite closely together which is why you get
this movement to the ear wax so when you get a grip on you'll see that the whole
thing seems to move but just not enough to be able to get any kind of meaningful
grip on it so we're gonna switch back to the crocodile forceps again and see if
we can try and take out one of these pieces of ear wax that are bound together
you can see as we get a grip on it it's just pulling but that back end the ear wax
is still holding it in quite firmly
there we are so quite a large piece there left some behind at the entrance
to the ear canal now we're starting to get the first glimpse of the eardrum now so
we know we're we're getting somewhere now as far as this ear wax is concerned you
just so dry that the underside of the ear wax is isn't a lot of bits of white dry
skin there okay so I can just see the top of the eardrum there that little to
the gray patch of skin you can see in the top portion of the ear canal it's gonna
grab this leading edge you can see it's almost like layers upon layers of dry
plates of ear wax in here gotta be a little bit more careful now so I'll see the
backend of this ear wax is gonna be that a little bit closer to the drum you can
see the top section it was just folding back a little bit so if we can detach
this front end here here we go it should allow us to get a
better grip on the piece that's behind there we are now you can see a lot more
of the ear drum here dry myself locations shiny but we've got one piece
of ear wax that's sitting quite deep in the ear canal there we go
and there's the eardrum we can see all the dry skin around the outside edge as
well there so this is the same patient over the other ear no not as much ear wax in
this side there was a little gap at the top here but rather than that it carry
on and gets to the kind of levels of ear wax that we saw on the other side we said
we'd address this one today so you can see just as dry as the other ear and
just as narrow as well so it's not still not the easiest ear to work in but
because we have got this little gap it means that we can work just beyond the
edge of the ear wax and roll it forwards out of the ear ear canal which is what we're doing
here so getting rid of some of these drier pieces
and we're quite a large lump of ear wax just in the base of the ear ear canal here so I'm
trying to work this down the ear ear canal but you can see just how tough it is and
where it's really kind of pressed into the base into the bottom of the ear ear canal
you see it's almost like a plate and as we're lifting from the front end is
actually raising the back end of the ear wax a little bit so we're just going to
triangle a little bit deeper
just so tough you can see the eardrum there so we can see the back end of this
is not touching the eardrum which is great there is a bit of a gap there but
you can see where it's all kind of quite firmly attached itself to that the right
hand ear ear canal wall so why do we know is trying to get between the ear wax and the
ear ear canal wall to lift see if we can lift this front end because sometimes if you
detach it enough you can get behind and get the traction you need to take this
out you can see it's really really not budging very well so crocodile forceps
going in hoping if we can get between the ear wax and the ear ear canal wall with the edge
of the forcep we can lift and get it off the ear ear canal wall you can see just how
firmly attached that is try and loosen it off the ear ear canal wall while pulling at
the same time so it might you can see there was a little bit of movement there
see all these little dry flaky bits okay now we start see a bit of movement to it
there you see it lifting off the ear ear canal wall now getting behind it
bringing it forwards again because he's just so much dead skin as underneath
this that piece of ear wax has been trapped against that ear ear canal wall for quite some
time big old chunk there there's the drum little tiny bit of dry skin there
and dry ear wax so I'll just get rid of that there's the drum itself all looking nice
and healthy so as you can see there was a fair amount in here what we've got
eleven and a half centimeters all together between both ears four and a
half inches so a very very deep seated dry ear wax you very much for video
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