hi everybody my name is Rhys Barber I'm the audiologist here at audiology
associates thank you very much watching our video today if you've never come
across one of our videos before or if you haven't looked at the channel before
what we do here is post ear wax removal videos we post new ones every Tuesday
and every Friday so if you have any questions about the video that you go to
watch then pop them into the comment section below and that way then the most
popular questions we can answer at the end of the week so enjoy the video and I
shall see you at the end so we have a bilateral ear wax removal for you today guys
so in this first ear you can see that we have some very dry ear wax really solid
so I've put some olive oil in here which just helps to loosen more than anything
else this the ear wax from the ear canal walls this is usually from cotton bud or
q-tip use because you've got the center section push much deeper than these
pieces on the ear canal walls coming further out so it's where the head of the cotton bud
the q-tips gone in so what we're gonna do first of all before we can take this
ear wax aways we need to unstick the majority this ear wax on the ear canal walls
we're just lifting it from the ear canal which you can see we're managing to do
just here this is the standard size zoellner tube that we're using here today no
we've lifted it we use the crocodile forceps just to get underneath and lift
that ear wax up a little bit more I apologize my voice sounds a little bit
weird today I've still fought it with a head cold unfortunately so we're just
getting a grip on this ear wax and just pulling it towards us you can see the
layers of skin underneath where this has actually been sat on top and so the dead
skin underneath doesn t able to come away it's held together with his which
in this case is helping us because it means we're getting the whole thing out
or the majority without in one one larger piece there we go
you see all the skin underneath it that came away with it so when we're looking
now we can see the eardrums exposed we have this whole dry skin section at the
top so we're gonna use the same process just to remove that as well so still
using the standard size zoellner tube to start us off but be a little bit more
gentle here because that back end of the ear wax is actually quite close to the
ear drum while we're just watching this bit just want to say a massive thank you
to all the guys who came along on the premiere the other night it went down
really really well I just fantastic session where you guys meal to answer
some of your questions say hello to the subscribers was really good so we're
definitely do another one of those because it was received really well I
think it's coming away there nicely and we're just gonna work on the last piece
on this side okay so we've pulled it down at the center so we can get a good
grip now with the forceps there you go just twisting it into the right position
to get a grip you can see it's just pulling away some of the hairs rather
than gripping the main body of ear wax so there you go nobody comes okay so you
can see the eardrum there's a little bit of dry ear wax which we're gonna take away
now on the right hand side while we're doing this guys don't forget if you've
got any questions you want to ask us you can pop them into the comment section
below the most popular questions we get during the week then I will put a video
together answering those questions probably the following week if that's
okay so don't forget to pop any questions you might have underneath you
go is the eardrum took you're nice and healthy okay so this site you can see
that's very different this is more skin tissue so this looks like keratosis
obturans this gentleman's come through because we
know he has a perforation on this side he's aware of each other for quite a
long time it's a well-behaved perforation we've got all this excess
dead skin that's hanging around in here so if you did wanna know a little bit
more information about keratosis obturans I'll pop a link up in the top right-hand
corner and also into the description below so we've done a video on that
already and you can see it's starting to come away and we've got a gap in the
skin now so I'm going to switch from the forceps to a Jobson horn I want to
detach the skin from the top portion of the ear canal here so just pull it down
there you go you can see it all starting to come away the skin that is are just a
little bit too loose to get hold of properly with the jobson so
I put the crocodile forceps the Jobson horn works really well on this type of
material but the crocodile forceps will just pull straight through the middle of
it so you can see the layer see the rippled
layer of skin here that you can see directly in front of the camera there so
that's what we're trying to remove and kind of pull this down the ear canal away
from that perforation so I can't see it yet she's just pulling through this
softer material dragging it to the front to take it out of the ear canal there we go
let's pulled that long strip of skin that we could see earlier with it a
little bit more behind there now now with keratosis obturans which was
explained in the video about it earlier you can get some degradation of the skin
underneath so actually degrades the skin at the skin of the ear canal wall which is
what's happened here I'm starting to get these whiter pieces coming away and
that's normally indication that it's degraded the skin underneath as we
suction here you'll see they use that whiter skin just under the as on the
tube is suctioning so it's actually start the piece actually start to eat
through the layers of skin underneath so you've gotta be really careful taking
this away I don't want to take too much of it away because I want the skin to
repair itself and looking at how deep that goes we could keep taking that way
taking now that way taking that way it's just gonna just gonna keep going deeper
and deeper and eventually you will probably hit bone
so what I'd prefer to do is take as much of this way as we can I'm just gonna
start to see the the perforation there you can just see the perforation past the zoellner
tube take as much of this way as we can but do leave some behind so
the skin can start to repair itself we don't wanna leave this patient open to
infection which they obviously would be any way with the perforation they so see
is quite delicate in here just trying to slough away some of the top layer of
dead skin I wanna go too deep with the the Jobson because it can be quite
uncomfortable for the patient especially like this so there's the subtotal perforation
if you wanna know a little bit more information about perforations then
we've also got a video of perforated eardrums as well which you can take a
look at up or a link to that and top right-hand corner
description as well a subtotal perforation means it's a very large
perforation as almost the whole of the eardrums gone we'll get a good look at
the perforation in a second we're just still taking away some of this some of
this debris obviously you if you follow the channel for a while you know we've
done it we've also done a section on perforation recently but I was a much
much smaller perforated eardrum so if you want you can check that video out as
well I'll put a link to that in the description and that will basically just
tell you about the you can see the different sizes of perforation and
compare that one to this one you'll see this is a much much larger perf so the
skin because it's such a large perforation the skin hasn't been able to knit
back together you can see the tip of the hammer bones still visible which is the
little white bobble just central screen there now just the top of the skin
that's left of the eardrum through that hole you can actually see the middle ear
space as well so quite a lot going on for this gentleman on this side okay so
I'm not going to take much more way now this is it so there you can see the
white bubble to the top right corner of the screen coming down a thats the actual hammer
bone and then you have this middle ear space you can see visible there then as
well so this is what we removed I've got the ear wax these two first one two three
pieces they are from the first ear the Ranger is from the second you've got the
crocodile forceps standard size zoellner tube ent fine and I'm Jobson on it
almost got the full set there to see in which you can get an idea of the sizes
of those as well you can see the skin layers we've got
built up there as well thank you very much for watching our video today if you
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little bit more about us as always guys until the next time take care