hi everybody this is Rhys barber from audiology associates thank you very much
for watching the video today we have a bilateral ear wax removal for you today
couple of people ask what bilateral means just means both ears so we have you can
see some quite solid pieces of ear wax in this in this ear canal so we're just
using the standard size zoellner tube it's going to grip on some of the softer bits
of ear wax on the outer part of the ear ear canal there but a few people asked us
recently how we clean things like there's zoellner tubes these are
disposable so basically we use a fresh one on every patient all the tools you see us
use our one time used tools
it's quite difficult to get a grip on this with enough suction force to get a
really good suction grip on it the ear wax is almost stretching and pulling as we
take it out of the ear canal so we're feeding the suction tube back
onto it to get a better grip then stretching a bit more feeding the
suction tube on stretching a bit more just helps us to get a better grip to
take it out you can see we can get a bigger chunk coming out now you can see
where that ear wax has stretched and pulled so it's a much more longer cylindrical
shape get rid of some of the excess bits there it's a dry skin and tackier
thicker sticky ear wax in there
got some quite deep-seated pieces in here now so just working a little bit
deeper into the ear canal you can see that as the skin is pulling here to the
right-hand side that's got to come we can just sort of come away there we've
got to go that a way to get to the piece of ear wax behind otherwise the skin gets
sucked into the zoellner tube and we can't get a good grip on the ear wax that's behind
it then you see
can you see me about the skin lifting up and blocking our suction so as we're
trying to get to this ear wax behind at the skin that's sitting in front is just
lifting stopping us from getting a good grip just clean the camera we'll start
looking a little bit little bit misty there what you find sometimes the
patients have used a bit of olive oil before they come in it can stick to
those little cilla little hairs as you pass through it with a camera it can
just just smudge the lens looking for any gap around this edge of this ear wax
something we can get a good grip onto
dry skin is just there we ask just on the lift away so you can see we can get
to the the ear wax behind it now a little bit more easily
getting the first glimpse of the eardrum there to the right of that ear wax now so we
know we're a little bit deeper in the ear canal
now again so there's some of the deeper pieces you can see what's actually been
stuck to the eardrum as well
this becomes a little bit more awkward at this point because we can't
effectively get to that ear wax where else we put a much thinner tube on no to try
and get to that piece because of the anatomy of that part of the ear canal
it's quite sensitive so we're aiming to get the center and bring it forward so
there you go just peel it away from the eardrum bring it forwards that way
working really close to that left-hand wall there is really sensitive for the
patient and you know our goal is to get this patient hearing better and to do
that we just need to open up the you drum they'll hear better now as it is
there you go I'll see the ear drum they soo much
drier ear wax on this side you can see the difference in color it looks a different
texture as well so we're just going to take some of the harder lumps of ear wax
away with that with a zoellner let's see if we can get a good grip on that to take
it away
all right what you can see now is there's a gap above the ear wax it can just
see the edge on behind so we're going to use the st. barts hook now to go in so
we're just aiming to get behind the ear wax with the hook and bring it forwards you
can see just a tough this ear wax is it's just not budging we're just pulling into
it there you go now we've got the movement we need lots of people ask
about that the st. barts hook I personally find it works best when
you've got a good gap above the ear wax so you can really comfortably get in there
and get behind it bring it forwards and you can get a good visual as to how far
back you need to go I don't really like using it when there's an or a great deal
of space above the ear wax because I find it's really uncomfortable for the
patient so this was a perfect one to use it which is what you don't see us using
it too often there you go come out a nice nice big chunk yeah a little bit of
tidying up to do there he goes and there's the eardrum so that's what
we removed so obviously everything up until about seven and a half centimeters is
from the first ear the block at the end they was from the second ear so this is
just how much was in there that's the st. barts hook standard size zoellner and
the ENT fine end there you go well as always guys if you did enjoy the video
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on a Tuesday and Friday and as always guys take care