hi everybody this is rhys barber from
audiology associates thanks very much
for watching our ear wax removal video
today
just one patient in this video
this patient came through
very very blocked up in both ears really
just
not hearing particularly well you
know when they lay on their ears they
feeling really blocked up their ears
were popping
or doing all sorts of different things
now when we take a look in this ear you
can see we started already here with the
the standard size zoellner tube
if you're new to the channel
this is one of the larger suction tubes
that we use
so you can see us just gently teasing
this away
so i'm working on the surface of this
ear wax and just trying to lift it away from
the canal walls first now
ear wax will naturally settle into the shape
of the ear canal
so what we're trying to do here is
move its position
so it tends to stick a little bit to the
canal wall so we're just
lifting it up and when we lift it then
you can see the
ear wax a little bit more mobile now we
can get a grip on the bottom edge and
just start to slowly draw this forwards
which is what we're doing here
the reason that we're wiggling
the tube and making this
little little movements on here is we're
detaching it
from all the canal wall sides first
before we can try and work this out
a lot of the time when you get these
bigger plugs
they form to the
shape of the ear canal when you get to
the outer part of the ear canal then
they don't always come away very easily
they get a bit stuck so we're going to
switch tools now
go in with the jobson horn and that's
The
little spoon-shaped object you can see
there and we're just going to draw this
forward
now that just scraped across the surface
of the ear wax this we're going to go in a
little bit deeper
the key to it here now is obviously
getting behind the ear wax to draw this
forwards
so we've got behind that section there
you can see it's working its way
very slowly out there we are now we'll
go behind the next section draw that
forwards
out starts to move that plug
so we've got a nice big
plug of ear wax there
so we'll just hold it up so you can see
it you just got a better
idea what it looks like
so quite a big old plug of ear wax in that
ear canal now so we're just
going to take a look behind that in a
second
and what you'll see is that
we've got even more ear wax in here so
there's a little bit more
just got the little cilia coming in
front of the endoscope there a little
bit
and we've got this darker
slightly harder plate of ear wax that's
going up at an angle so
as you're looking into it it's
sloping up towards the roof to the
ceiling of the
the ear canal there so we're just
going to get a grip on the bottom
and try and manoeuvre this out now when
it forms in this wedge shape
when you lift the bottom you end up with
a very thin leading edge so it's
sometimes a bit difficult to get
on there with the suction tube
so we're just going to switch we've got
the crocodile forceps in there now just
to see if we can grab that end piece
but that's all it's done because this is
very thin it's clamped onto that and
just taken that away so we're going to
go back in now with the jobson horn
let's see if we can just just sneak over
that top edge there
and just draw this down the canal so we
managed to get a piece out
let's just move that out of the way see
if we can get over this next section
without pushing it back in
now it's got this very clay
or very fudgy type texture to it this
one
so as we're pulling down it's just sort
of just scraping that top layer
off but that does open it up a little
bit more so next time we go in as we are
here now we can leave that a little bit
further down
and that's just going to start to roll
this ear wax forwards which is what we can
see here
here we are starting to pop
there we go look how dark that material
is now
when we talk about ear wax and how old ear wax
is
ear wax when it's newly formed is a
very light creamy color
but it's very dark so it's been there a
long time eardrum looks nice and healthy
here
good light reflex there slight graying
to the eardrum but that happens with age
so it's
nothing to worry about there
the ear wax when it becomes older it
oxidizes so it gets this much much
darker appearance almost this ebony
color so we've got one ear canal
that's lovely and clear patient hearing
so much better on that one side but the
other ear here now
this ear wax totally different texture
whereas the other one was more like a
fudge texture
this is just solid and brittle so as
we're working this with the jobson horn
you watch now as we put pressure on this
see it you can see the jobson just
flicking out of the ear canal
so basically as we're trying to put
pressure to draw this forwards it's so
hard
it's just cleaved the front end of this
ear wax away so this is going to be a
slightly more
difficult one to do
we're sticking with the jobson horn
because we're working quite well here
with this we're breaking these little
bits off
and it's such an uneven surface that we
would probably
struggle a little bit with suction we
will use it to tidy up here and there
but at the moment we're just going to
stick with the jobson horn and what
we're doing is we're taking this away in
installments at the moment you just got
to break little pieces off
and then push those out into the
bowl of the ear down there just so
they're out of the way
and then you can work on your next
section but it had formed almost to a
solid plug
in here so a patient had been using a
bit of olive oil in fairness they had
been using it on both sides
but because this had just got so
hardened up it the the oil didn't really
penetrate into the ear wax very well
and as far as it did penetrate it only
penetrated into the surface so it didn't
go
all the way back so you can see now
we're still just chipping
little bits they're coming away tiny
little pieces
of ear wax into the bowl of the year
here we are as the next section coming
forwards while we're doing this bit guys
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haven't seen one of our videos before
we post new ear removal videos every
monday wednesday and friday at 9 00 pm
uk
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guys like to be called so
we've got a lovely community of
waxaholics so feel free to say hi in the
in the community 209 00:05:56,720 --> 00:06:00,479 if you've never seen one of our videos
before so we're just drawing this next
section you can see we've got to
another hard piece but it is staying
together it's not quite as brittle
so we're able to start drawing this
larger piece there we go look at that
one coming away
you can see that lighter material at the
front we're drawing this darker material
down with it
look at that plug out that comes i think
it's a bit too tough for me to even get
the jobs and horn in there but it's a
nice size we'll pick it up with the
suction here this is a lighter material
underneath a little bit of dry skin
there but a fair old size plug there as
well
and then if we take a look behind that
we've got more in there again
we've got this little lip of dry skins
come off the one side here so we're
going to use the suction just to grab
hold of that
and give that a bit of a wiggle let's
see if we can pull this next section
forwards there we go that's that bit of
dry skin gone
and then if we take a look behind that
there's more in there again so we've got
this
much deeper very very dark
section here which we're going to start
breaking away with the zoellner tube
there we go and let's pull the next
section
forwards getting a good grip let's try
and manoeuvre this
bit of a gentle wiggle to draw this out
of its space
there you go and work this down the
canal i think we'll get it so far
i don't think this is going to make it
out on its own so we'll go back in there
with the jobson horn
dropping over the top
just spinning this ear wax rolling it out of
the canal here
it's got a little bit wedged let's see
if we can get behind it
here we go it's starting to turn let's
see if we get behind it again draw the
rest of the way out and
out it pops and out it comes
so i'll pick that up now with the
with the suction tube
we'll have a good old look
behind this now see what's going on
anything left in there
well we can see the eardrum there but we
have got this little bit of
so a little bit of dry skin at the
entrance a little bit of dry skin at the
top of the canal and a little bit that's
just dropping over
onto the onto the pars flacida that
top part of the eardrum above
the tip of the hammer bone you
see there
so we're just gonna work our way with
this bit
and pull this down there we are you can
see it just starting to pull down you
can see a cilia just a little hair
just
popping over the front there and looks
like there's a little bit of a dry skin
lift there so we'll
we'll just but there we go out it comes
so that peeled away really nicely
let's have a look behind that there we
go there's the eardrum there good light
reflex a little bit of graying of the
drum
that's something that just happens
as we get a bit older it
becomes a bit more opaque
look at what we removed though we had
six centimeters that is two and a half
inches of ear wax between both ear canals
there if you remember the ear canal is
only about an inch long
so yeah when you when you look at it
side on there you can see just how big
how chunky some of those pieces are lots
of little bits interspersed in there so
quite a big old
ear wax removal that one with both ears
patient over the moon to get that out
hearing
so so much better right then guys as
always
well i hope you enjoyed that video as
much as i did voicing it over as you
could probably tell while I did the voice
over
but as always guys take care of your
ears take care of yourselves take care
of one another and i shall see you for
friday's video bye guys