hi everybody my name is Rhys Barber I'm
the audiologist here at audiology
associates we upload new ear wax removal
videos every Monday Wednesday and Friday
at 9 p.m. UK time so please consider
subscribing hi everybody this is Rhys
barber from audiology associates thank
you very much for watching out you
action move all video today one patient
in this video this ladies come through
with some very very deep hard impacted
ear wax you can see that there's a
little bit of a concave sort of dip in
the centre of the wax there which is
classic for somebody who's used a q-tip
and you can see that the centre there is
really dry it's dried onto the ear canal
walls try to use the suction tube here
just to loosen any part of this we can
see it's really firmly attached there
it's really solid in there so we're
going to need to be able to get this off
the ear canal wall first of all just to
Train free of that so we're gonna use
the the oval end of Jobson horn here
just trying to find any sort of looser
section any gap you can see that that
that part of the ear canal is quite narrow
is quite small so we've got a train get
this just leverage just behind it now
don't normally tend to use the jobs and
hornless deep but you can see we're
really able to sort of pull this I just
want to get a little bit of movement and
a little bit of detachment from the
ear canal wall here just pressing pushing
again so you can see that it's quite
solid this front end of the wax here so
it's not really sort of moving it much
it's just more sort of scraping on the
front and just just puckering this
section up at the front here so because
we've got this little Ridge another
glimmer that the crocodile forceps now
see if we get a grip on this central
section just slowing everything down so
you can see what's going on so you can
see we've got a little bit of movement
did you see it just pulled forward but
then the front section detached so we'll
just bring that out to the the ear canal
there now we've still got this little
Ridge here okay right in the right in
the centre of the wax so I'm gonna carry
on with the forceps for a second just
see if we can get a grip so now this is
loose skin
to the bottom-right corner just trying
to get a bit of a grip I don't know if
is enough it's not quite prominent
enough to be able to get the top and
bottom jaw over that so I've opted to
use the fine n now it gives me a little
bit more room in hue don't get this much
suction so you don't get such a good
suction grip but it does help us to
really get a bit of movement in there
I've just turned the brightness down of
the scope as well so we've got a lot of
glare from that dry skin in there so I'm
just could turn that down you can see
it's just not really budging so I've
flooded this with olive oil that's going
to help it to detach from the ear canal a
little bit more effectively and it's
going to help it to slide if we do get a
pea grip on a piece of wax this is a bit
of dead skin here so I'm just trying to
loosen that off because it's the dead
skin that's been holding this chunk of
wax in so I was hoping if I could get a
good grip on that a little bit of dead
skin it may especially if it's in deep
enough into the wax it may bring the wax
forwards but as you can see it's just
clearing from the side there's a little
gap to the right side there I'm just
trying to get the fine end into it
because another jobs and horns is going
to push in there we go so you can see
it's move that frol front section
forwards there so just switching back to
the wider end now so I can get a grip on
this piece to the right hands to the
left-hand side sorry just managing to
get a grip on this just fighting with it
a little bit you can see how hard that
dry skin is holding everything in place
and this is a particularly awkward
position to have the wax in just because
it is very cheap which doesn't give you
a great deal of room it's very small but
the shape of the wax is awkward's now
we've got this flat section at the front
here so we're just going to try and pull
that piece away they have just slowed
that down so you can see what's going on
but the section behind this now has a
very thin front end with a very wide
rear section annele it's embedding a lot
of this dry skin as well at the base of
the ear canal so the skins holding it in the
shape of the ear canals holding it and the
shape of the wax we're all working
against one another which makes this
particularly difficult so it's gonna
you're gonna see we going in and
maneuvering this wax quite a bit so
while I'm doing that I just wanted to
say thank you so much for your
understanding over the last two weeks
it's been crazy here we've had lots to
do here we've been trying to update all
our computer systems to make us as
paperless which took a lot time and
we've also expanded the clinic here in
our Vale branch so it means that we've
actually expanded into the room next
door which also took a lot longer than
we thought it would so we've been very
very busy the people last last couple of
weeks but it doesn't mean now that mrs.
B has her own home next door which is
going to mean you're gonna see a lot
more on the social media side of things
coming on along over the next couple of
weeks and months we also broke 200,000
subscribers I go away for two weeks and
you guys go crazy which is absolutely
fab so thank you so much for that as
well
we really appreciate all your efforts in
sort of sharing and liking our videos if
we do disappear for any reason we always
put on the community tab on YouTube so
if you are looking if we if you think
something's up or you don't see us for a
little while pop over there it'll do she
explained what's going on but thanks
again guys it was much appreciated and
hold you hope well wishes well I'm sorry
I panicked you all you all thought it
was not very well so we've managed to
get this little piece of wax now much
further down the ear canal and you can see
we've just got a little bit of a ridge
to work on here it becomes a little bit
awkward because we have a very thin
front section to the wax here so and
it's very dry which means the suction
can't get a really good grip it's very
crumbly which means the July the
crocodile forceps are not getting a good
enough grip and hot being able to hold
on without breaking a section off the
front and it is so close to the eardrum
that we can't get behind it with the
Jobson horn or the st. barts hook so
just a real stubborn piece of wax here
it's not it doesn't want to play ball
I'm trying my best to grip it from the
sides there you go you can see what I
mean it being crumbly you can get the
grip but as soon as you get put any
pressure from the jaw
onto the wax its GS crumbling underneath
so I'm trained to reposition this piece
of wax if I can going back to the fine
end because it's going to give me a
little bit more movement with a suction
tube it's trying to peel this section
here from the left-hand side of the
ear canal wall across to the right side and
back again there's a little gap at the
bottom here so let's see if I can get
the jaws underneath this and we get a
grip and it starts to come forwards and
then it breaks and then you can see that
you because it's come forwards now we've
lost that little edge to work on so it's
back in there with the with the fine end
here just to bring this forwards
trainer work down either side I'm trying
to turn the wax because as it stands at
the moment we've got this kind of you
almost like a little bit of a u-shape to
it so you can see the forward section
here it kind of bends back on itself
just to round that corner to the
right-hand side so I'm trying to lift it
and bring this narrow edge through and
then try and turn it to to get it around
that corner but as you can see it's not
really playing ball at the moment it
doesn't want to come out easily now
there are two pieces of wax here we've
got the main bulb which is to the
left-hand side in this smaller piece
here to the right both of which are
attached to some dry skin underneath
which is the two layers are one over the
top of the other which is what's causing
this a little bit of a problem because
you get a bit of movement and then that
smaller piece at the top holds it in
place and the skin is holding everything
in it doesn't want to let it go this so
dry this wax okay it's going with a
larger tube now to see if I can get a
better grip lots and lots of switching
tools on this one just trying to find
anyway again that's out I mean the
reason this ladies comes through to see
us she's has hearing aids but struggling
to wear them at the moment really not
getting on very well with them because
she just can't hear very well this is so
deeply impacted into her ear and we've
introduced a little bit of olive oil
here just to try and lubricate the ear canal
see if we can get it help us to get a
grip of the suction as well it's trying
to soften some of that skin it kind of
has lots and lots of different effects
in there so we can't leave this in place
because this poor lady isn't really not
hearing very well and she's struggling -
your family okay we're gonna go whoop
just coat the head little bit of olive
oil so we're gonna grab this now we're
just trying to find any palm trying for
a little bit of white skin you can see
at the top because sometimes when you
get hold of that skin because it's in
into the wax it'll hold on really nice
ease up but it did get a bit of movement
so I'm going to trail Ian's move it now
to get a better grip you can see the
white layer underneath that's that dry
skin which has just been holding
everything in place screens got a little
bit misty cuz the olive oil the switch
to it I'm not really getting enough
movement with the standard size on the
tube so I'm going to switch to the fine
end again now
just try to roll it forwards you can see
how loose it is it's it's moving back
and forth really easily but because it's
got this section you can just see to the
left and underneath that white layer
that's the skin section that's holding
everything in place I'm trying to break
to break that kind of adhesion in there
I've got a little bit of a gap we're
going to go in with the crocodile
forceps now hold on to it
there you go that's it broke away again
there we are
now we've managed to pull out top
section forwards now it's you can see
it's crumbling underneath it is going to
come away though we've got it further
forwards we've managed to do before
let's hold on to it now see if we can
drag this across to allow us to get the
forceps in more effectively but you can
see it's just so brittle in there it's
just to try and even get a grip on it
with the the suction he was proving
really hard even though with a narrow
end they're really trying to kind of get
any grip I can you can see it's just
pushed it further in though I came very
very close to giving up on this well and
having this lady back in it in a week or
so his time soften up a little bit but
bless her she was so desperate to get
this out we had the time so she was
happy to sit through and get this done
you can see that white layer again there
like that skin layer underneath you can
see the ear canal is quite pink you know
some of that's gonna be irritation from
the wax some of that's gonna be just the
dryness of the skin and there now we've
got a good a good layer there to get
hold of we've turned the wax oh we've
got a good layer just be really delicate
positioning the forceps we've got a grip
and there it comes okay we got it out
have a look at this now I'm going to
turn it on its side when it comes out
the ear canal and have a look at those two
white layers those two layers of the dry
skin now that's what's been
anchoring this into place near that
eardrum and the one it just wouldn't
budge it was attached at the top and
bottom there in two different sections
so we can see the eardrum there yes
there's a lot of pinkness around the
outside but then that wax has been sat
down in there the skin itself is very
dry there's a tiny bit of wax here to
the right-hand side just to the right of
the fine end there we go that's taken
away now and there's the eardrum looking
clear that's just very dry skin red dry
skin in there so it's the patients
either yep so we've got a second-ear to
do you can see that kind of dry
crumbling us to the wax on this side as
well you can use the standard size sauna
here just lifting from the bottom just
start to tease some of these piece of
ways we put a little bit of olive oil in
just to help this along there we go you
can see do you see how it detaches a lot
more easily from the ear canal walls this
this dry type of wax when you put a bit
of olive oil in there as you can see
it's coming away in installments are
lots of little dry flaky pieces coming
away just try to detach from the left
ear canal wall and the bottom there as well
just slowing this down because you see
that piece getting sucked in there you
can see the skin lifting from the base
of the ear canal look as we take that piece
away then we detach that top section a
little dry section coming away we go in
now we've got this ring of dry wax and
dry skin there so we just get a grip on
the bottom section and watch what
happens it starts to pull on that layer
of dry skin the dry skin starts to
detach and comes away from the ear canal
walls we start to bring this top section
down so you can see it was one
continuous piece or held in place by
that dry skin so really just pulling
this top section away there we go so
voice you starting corner and then we
can see we've got a few little
straggling piece of wax left over so we
just pick these little dry bits away you
go you can see all getting sucked into
the tube there we've got a piece top
right of the drum and to the left-hand
side as well so we'll get the left hand
piece first there we are it's a dry
section there and then we'll go back in
now let's collect this piece just to the
right side just staying away from it and
I'll sit suctioning it towards us here
we go there to the left a little bit
there to the top so we get those bits as
well there we go you can see those
feathery dry bits of skin there there's
the ear drum there and this is what we
want so it looked massive but it was
quite a small piece but lodged in a
really difficult place to to maneuver
around so two and a half centimeters all
together an inch worth of wax in both
ears thanks for watching guys and I'll
see you on Wednesday