hi everybody this is rhys barber from
audiology associates thank you very much
for watching our top 10.
uh we're on uh the top two so this is my
second favorite uh video anyone
who's watched our channel knows i love a
challenge
i love a good skin peel and i love an
eardrum peel and this had everything in
it so this
lovely gent came through with a fungal
ear infection now it's really easy
to get fungal infections in your ears
it's quite common and normally you can
treat it with other
over-the-counter drops which is exactly
what this gentleman did
but what you end up with then is this
kind of thick uh
layer that builds up around the ear
ear canal walls
and over the eardrum as well so what
you'll initially see here is lots of
kind of dead skin which kind of killed
off the top layer of skin there and fed
off it so
we're just taking that away uh which
looks like a really thick
um i hate using foods now she's gonna
get so much stick with it
but you're if you if you're a custard
you have the top layer of a custard the
skin we call it here in the uk
or gravy you get the same thing it's
kind of like that
consistency so this kind of thicker but
a little bit more liquid underneath
that's what you can see so what we've
got here we're just taking this away you
can see the little
uh spores you can see the little sort of
little tiny
uh they look like very fine haze almost
almost like cotton wool sitting over the
top of this
so that's the actual fungal infection
itself so this is actually coated
the eardrum and all the way down the
ear canal as well
so what we're doing at the moment is
just peeling this all the way back to
uh the eardrum and then we're gonna do a
little peel on the drum as well so we're
just taking this away
i've turned the brightness up a little
bit because it's it
the gentleman's got uh because it's
obviously aggravated to the ear canal
it tends to swell up just slightly which
has narrowed it down so you don't always
get the best amount of light in here so
just turn up the brightness a little bit
there we are see how it peels and kind
of peels away in chunks and starts
coming away
there we are just down the peel from the
top now um if you've never watched one
of our videos before uh
normally i post new e-ear wax removal videos
every monday wednesday and friday i'm
actually on some leave this week so
which is why we're doing the top 10
but if you haven't seen our videos
before and you are enjoying them don't
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so i'm just you can you see at the top
left hand corner we were just working
uh we've just got a little bit of appeal
it's just peeled down into the ear canal
there
and when i was starting to loosen all
around the outside edge
this is the fine end in here because
we're working so close to the ear canal
walls to get that peel
um it's difficult when you're looking at
the standard size on the tube you can't
really see
as you're looking down that what you
what you're kind of pushing into as far
as the ear canal is concerned
because the top of the standard size
will stop you from seeing it
so we use the fine end which gives us
get you know a good gauge as to where
the ear canal is going because
don't forget they're not always straight
they will go up and down the left and
right
and as you're kind of pushing along
we're peeling so close we don't
accidentally dig
the uh the the sort of suction tube into
the ear canal wall itself because that will
cause
uh you know a bit of discomfort for the
patient but it can also risk bleeding as
well
so really starting to peel this away now
see how it's you getting that lift look
at the material as it lifts
you'll see what i mean about that kind
of that that thick
uh that thick layer there
now imagine that's covering your ear
ear canal so if you imagine you've got this
kind of
thick uh sort of
this thick sort of skin layer almost of
of
of uh wet debris underneath and this
thicker tougher layer on top
covering your eardrum what's gonna
happen is your eardrum is only three
uh three skin skin layers thick so
basically what's happening
when the sound normally hits it that
eardrum can vibrate really easily
if you've got this thick build up over
the top of it then what's going to
happen then is that your drum can't
vibrate the way it should
so this patient not only do they get a
little bit of discomfort they'll get
itching in here
the sound will be dampened so it can be
quite problematic
and especially with you know when your
jaw's moving your yoyo is constantly
flexing like this
when that's happening it's really going
to be causing some uh some irritation in
this ear canal
you can see the skin underneath is
really pink where it's all been
aggravated in here
what we will do with patients like this
sometimes is if they they've come
through an infection it's a full-blown
infection
then we'll go away get them to treat it
first and then we'll take away the
majority as we're doing here
and then tell the patient to go away
treat and then come back after the
treatment stand
because what can happen sometimes you
can leave remnants behind in here that
need to be peeled away
and they will go quite hard at that
point as well
so you can see we've got this kind of
this thin layer at the base
of the the ear canal there
and now we're just trying to pull down
from the top here
i'm trying to get a good enough grip
that it doesn't tear too much because i
want to use the
there you go you see that peel away i
want to use the the the structure of
this material
against itself almost to sort of pull
this apart so we've opened it now we can
start to see the eardrum there so let's
start clearing the top wall as well
so this is what we refer to as the attic
so this top portion of the uh
the ear canal here
oh that's come away see how that peels
away really nicely
you can see it just sits on top of the
skin it it kind of just kills off that
top layer and just sits there
but that's a good peel there
always very very conscious when you're
doing this
of patient comfort as well don't forget
these ear canals are
aggravated they're uh tender
they can feel really itchy and then
you're kind of peeling stuff off them
you've always got to be checking in with
your patient making sure that they are
comfortable with what you're doing and
uh you know they're not experiencing any
discomfort
see our p so we're slowly uncovering
here so
we're peeling uh from left to right
at the moment so we're just kind of
drawing this across this is
one big chunk i'm trying to hold the
suction tube there
which allows it to get a good grip
because the the suction builds and holds
on to that material really tightly
so we've peeled that section away which
is uh which is going to free up a lot
more of this
now we need to do the top section there
because can you see it's still attached
to the right and to the top going up and
over the top there
so we're going to work on that section
next see if we can pull that down
slowly working across this right side
now
there oh do you see that bit pull then
it started to pull away
what you can do sometimes if you get a
grip like that is if you draw
back uh it'll peel along the ear canal walls
coming away as well
which is what i'm trying to do there
trying to hold onto it enough that we
pull this way
normally we pull down or across away
from the ear canal wall that we're
uh working on but if you haven't got a
great deal of room in there another good
trick is if you hold on to it and bring
it
towards the camera then it just
naturally peels along the ear canal wall as
well
obviously it depends on how well it's
attached because if it's attached really
really well then what happens is as you
pull it
uh you just lose the suction grip
there we are we've got a nice big chunk
coming away there
and just trying to get a grip on that
next section
i'm just backing away with the endoscope
a little bit because it will help me to
uh maneuver the fine end
if you imagine you've got the endoscope
as
one sort of thin uh metal piece inside
the economy you've got another one then
you're trying to work
around the two so uh sometimes what
we'll do is we'll just draw the
endoscope back which gives us a bit more
room here without the two
crossing and clicking into one another
because that can cause the tool to jump
so it's uh so sometimes we do have to
kind of pan back a little bit
there we are do you see what i mean as
we pulled it it started to loosen that
top layer it started to peel that away
as well before it broke away
really really starting to peel away now
get a good grip there
it's coming away look at that peel
look at that peel away good
good sized chunk came away there there
we are lovely we just started exposed
look at the eardrum though the eardrum
is directly in front of you there now
that kind of pink patch with a gray
underneath
that's the drum so you can see just how
aggravated that is
and how kind of puffy that's gone
let's see if we can get this bottom
section now
we've got that little valley there
appear trying to peel across in there
sorry guys i keep finding myself doing
this try to see over the top um
just slowly working that away
gosh that's so delicate there okay let's
try further back
sometimes with these peels um you'll if
you start further back
you'll actually get the beginning of the
peel there we are see how we lifted
we were struggling to get a grip on that
little section just in front of the
eardrum there
but because we started further back now
look at the sort of thickness and the
peel we've got
there that's and that's actually
connected to the piece we need to take
away
look how far back that whole section
went
now we've got the difficulty of trying
to hold on to a re you know trying to
get the good grip on this base section
here
i've put the bigger end on here so this
is the standard size on the tube in here
holding it trying to get a good grip
trying to hold
trying to get as much into the suction
as we can to get a good tight grip on
this
that's almost you can see it flexing
it's lifting but it's
just not they've just started to see a
little bit of detachment
brilliant that came away really nicely
you can see just how tough that was my
goodness me
look how mottled that eardrum is you can
actually see the blood vessels coming to
the surface on there as well
really really aggravated
the good thing is now if if you use
drops at this point
um we've we've got rid of a good
majority of that
fungal infection so what are you going
to think of is if your fungal infection
is coating the entire
ear canal when you put the drop in it's
gonna it's gonna come into contact with
the top layer and start killing that off
now obviously you've got layers
underneath that which also need to be
treated as well so if we can get
rid of this top layer uh and expose the
kind of the
the thinner layers underneath and the
skin underneath it means that when we do
put the drops in then to treat this
it's going to have a much quicker effect
and much quicker improvement in there as
well
still peeling some of this dead skin
away
got the fine end back in here again
got these little tiny skin lifts i'm
just going to sort of draw from behind
and forwards that detaches the skin lift
and
it gets uh sucked into the uh the the
suction
tube as well then
you can see that eardrum there's still a
little bit of a mottled effect on there
look at this dead skin coming away
it's pulling away at you it's really
satisfying when you can make a big
difference of this when it's coming away
look at how all this is as built up on
the eardrum as well
just trying to slowly work around the
outside edge
lifting all this up
you can see it's almost formed like a
second skin over the eardrum there
now let's get rid of this section here
to the right
you can see a little bit of fl look at
that peel away did you see that
lift and peel right up the top so that
mottled
um uh material you can see there all
gone now look how smooth that eardrum
looks now compared to
it did a few seconds ago got this little
bit down at the base of the ear canal here
oh it's so frustrating this last little
bit didn't come away
holding on is it going to bind
ah it's almost there
there there they you just start to see
the movement now
do you start to see that kind of fold
down into the base of the ear canal
that's where it's just starting to peel
away there we go from that one side
we've got the peel going there now that
i'm peeling from the bottom of the
eardrum there
down into that little valley there we go
i love skin peels i think eardrum peels
are one of my favorite things to do and
this was
this was a real a real good one to do
just give me that last little piece see
how it forms these
thin thin layers and there's either now
that actually looks like an eardrum
towards the bottom there you can see the
hammer bone that coming at this angle
and you've got the eardrum there either
side of it all looking quite red and i
agree
it looks really pathetic if you look at
it there
but what we did there i thought was such
a tough one to do
but so satisfying to do at the same time
just because we could get that off the
drum it looked a heck of a lot healthier
this is what was actually in the tank so
you can see everything there as well
fabulous so that was my number two
of the top ten so coming next
uh on the next video is my number one uh
favorite
uh up until lockdown i would say because
i think my favorites might have changed
a little bit since lockdown but i did
compile this list during lockdown so
uh this was my number one favorite uh
on the next video uh so please watch
that one as well i hope you enjoyed it
if you did give us a thumbs up if you're
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and i shall see you for the next video