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 watching our ear wax removal
video today we've got two
patients in this compilation both with
dry skin issues
so this first patients got a very
blocked up ear here just the entrance
of the ear canal is very blocked up with a
ribbon of skin so a little flap of skin
has fallen down from the top of the
ear canal wall there so what we're doing
here is using the standard size zoellner
tube just to try and bring this out of
the ear canal just getting a grip on the
outside edge very slowly working this
down the ear canal holding the suction tube
onto that ribbon so that we get a really
good grip on there there we are just
slowly working this out maneuvering it
forwards just trying to get another grip
holding the suction tube on there to try
and get a really firm hold there we I
can just start to see it pulling away
and out of the ear canal now see is
stretching away from the ear canal entrance
sometimes when you get out this far it's
difficult then because you've lost your
your good grip so it's sometimes you
can't hold on to the suction with the
suction as well as we'd like so we just
going to go in there with the crocodile
forceps just aiming just at the top of
this dry skin just you need to get a
good grip there we go
and as we pull this out you'll see it
stretch here we are see unravelling as
it pulls away just slowing it down here
so you can see that's going to see the
long ribbon that's built up in there
there you go and out that piece come so
that was the flap that you could see at
the entrance is gonna look how wide it
is that I was taking off you can see where
fallen from the top of the ear canal you've
got these two sections here now left
right and there's a little bit at the
bottom there which is the remainder of
this dry skin so we're just going to go
in and grab those little pieces there
just taking each piece individually away
using the the forceps tends to be a
little bit easier sometimes when you get
these dry skin issues especially the
entrance to the
if you imagine tried to hold on to those
with a suction tube you wouldn't have
enough of a enough surface there to hold
on to with a suction tube which is why
we've gone in with the forceps there we
go and thank you to everyone who's been
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great and you can see here that which
yes - you get this bottom section of dry
skin away there we go just probably the
remains of that out now just slowly
tease another way there we go that's
come away nicely there and just a
reminder for everyone we are on
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quick look at this just taking this
bottom section now just trying to get a
good grip you can see it lifting that
from the base of the ear canal so we're just
gonna try and grab that bit as well just
tidying up this entrance to the ear canal
really here we go aiming for this
bottom section now it's quite
painstaking stuff when you take away dry
skin issues like this because it is
just a case of just going in you'll get
little pieces while coming away gonna
grab other jobson Horne for this bit
so you've got this sticky bit of skin
here at the entrance there you go so
just want to clear that away that
wouldn't come away when you tick with
the crocodile forceps but it is easier
to take away with this type of with the
jobson Horne so you just got a nice sort
of pull on the skin or puckers up and
concertinas into the Jobson horn then
here we go that's lovely this top flap
now we're gonna see if we can get this
away just going to turn the jobson
horn upside down now
it looks like it's still quite firmly
attached so we'll see as we pull it
there you go you can see we're just it's
very thin so yeah it's thin that piece
of skin was and there we go so a good
look behind there now so there's the ear
drum all looking lovely and clear now
eardrums got slightly milky appearance
so it's a little bit of thickening to
the skin there that's that flap of skin
we removed there at a centimetre you can
see and all the little pieces we took
away then from the entrance you see just
how wide that piece of skin was so this
is the second patient in our compilation in
this one I've slowed down in various
bits because I want to point out certain
things for you so patients come in very
blocked up via ear canal he has come in to
see us before so I have seen this
condition with him before but can you
see we've got this recessed section
there then pointing out so what we have
is is a an outer section this is all dry
skin that's formed a little sleeve
inside the ear canal going right the way
down in front the eardrum then we can
tell it's a sleeve because we've got
this little gap here look that separates
the ear canal wall to this little bit of dry
skin that's flicked up there which we're
going to point out there we go so you
can see that's come away from the ear canal
wall we've got that little gap so we
know there's a sleeve in there the
recess section shows me it goes in a
fairway so this is gonna be a really
hard piece of skin here it goes almost
like a leather when it comes away from
the ear canal walks it loses its blood
supply in moisture so what I'm doing
first is using the Jobson horn to lever
this dry bit of skin away from the ear canal
wall now what you'll see as I bend this
forwards as we go in there you think
that's the eardrum but it's not it's
actually a layer of skin in front of the
eardrum so this is one big long imagine
it like a sock or a sleeve of skin if
you like inside the ear canal so we're
working down the side of the that hard
bit of skin there were the forceps just
gonna give this a really good hold you
can see it see how brittle that was it
broke away and you can see just how
firmly it holds onto the ear canal walls in
here as well now we're gonna go in a
little bit further with the jaws of the
forceps taking a really good grip very
slow but steady pressure to move this
out can you see how this is coming away
it just snapped away again there
so it's very brittle this outer section
but it is helping to detach it from the
underlying skin and this so we get a
mostly a really good grip this time so
as we pull I've slowed this part of the
video right down because I want you to
see this sleeve as it comes out so as we
pull there we go now it's starting to
move so we're gonna bring the endoscope
back so we can see what's gone look at
this as it comes out long sort of hard
pieces of skin so that was just the
entrance section we've got a whole
section behind that you can actually see
how far down it goes so we're gonna get
a grip on this section you can see here
just on the outer part of the ear canal
with the forceps
and we're gonna slow this right down
again now watches this comes away okay
so we've got this really sort of hard
piece that's broken away again aim for
the next section okay now we should be
getting to the heart of it's behind the
sort of the main bulk of this skin plug
so here we go it's on its way there we
are can you see as it's coming away look
at the width of that and that's all dry
skin watch is still progressing out of
the ear canal so these are the sections we
could see much deeper sitting in front
the eardrum look at that plug you see
how hard we're at the last we
look at the length it's just gone the
whole length of the ear canal that is one
solid piece of skin now that feels hard
like if you round up a pile of skin on
the side you nail then it goes hard
that's that that's that the feel of that
bit of skin that's just come away
they're just getting rid of these few
pieces here at the entrance to the ear canal
we'll have a good look in here now in a
second same as the patient before we're
just tidying up the outer section using
the forceps to do that you have to put a
lot of pressure on those plugs because
they're attached all around the ear canal
you can see the ear canal there we've got a
few bits here at the entrance we're just
going to tidy this up a little bit you
can see some wetter stuff just there at
the entrance as well so we're gonna use
the Jobson horn to do that just to give
it a quick quick tidy around the edges
let's get rid of those little soft bits
there and just around the top section
here
and just inside there for those looser
sections okay so here we can see the ear
ear canal that's not white bit there
that's the skin that forms this plug and
you can see just how red and dry that
ear canal is there we're also missing the
light reflex that's where we would
expect to see it so that's the light was
shiny and bouncing back from the eardrum
and missing that so a dullness to the
eardrum look at the length that have
slowed the plug down so that you'd
really want to see this bit look at the
length of that plug when you're talking
that was three centimeters long that was
the full length of the ear canal and
just how thick and wide that section is
there we're gonna flick over to it in
inches now as well there you go so you
can see an inch just over an inch long
there that piece bottom section there
was what was against the bottom of the
ear canal so you can see just how long that
bit was going right down in front of the
eardrum as well so difficult one to
remove that one
thank you very much for watching our
video today if you did enjoy the video
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always guys until the next time take
care