everybody this is Rhys Barber from
audiology associates thank you very much
watching our ear wax removal video
today if you've never come across this
channel before we post your ear wax removal
videos every Monday Wednesday and Friday
at 9 p.m. UK time we've got one patient
in this video today I'm going to do a
quick explanation about the st. barts
hook we're not going to use this one in
the video today but it's the only toy
didn't cover the other day if you're not
really that interested in the tools but
you just want to go straight to the ear wax
removal in the line below me here is
what they call scrubber line
there's chapter marks in there if you
click on the next chapter it'll take you
straight to the ear wax removal if you are
sticking around for this explanation
this is the only tool I didn't show you
the other day which is the st. barts
hook so as you can see it's got a little
90 degree angle on the end there
this little tool is great for removing
harder sort of pebbles of ear wax you do
have to have a little gap above the ear wax
to be able to accommodate that this this
little 90-degree angle it also has to be
relatively short because what you're
going to be the way we use this is we
insert it into the ear canal kind of
flat and then as we go past the ear wax we
drop it behind and then use the flat end
of that main 2 degree angle to bring the
ear wax out so if you imagine if you've got
a very long piece of ear wax it's not ideal
because you're pressing down on as it
turns you're gonna pressing down on top
of the ear wax so it's not really going to
get behind it and get the leverage needs
to pull through it's also not great for
the softer type ear waxes because it's so
thin on the end there when you get
behind the soft ear wax I'm trying to pull
through it just creates a groove in the
ear wax it doesn't actually get rid of polar
ear wax out for you so here's a handy little
tool we don't use it very often here
only because you need a very very ideal
specific set of circumstances for that
ear wax to be able to take that out if you
can think of anything else you'd like to
see in the videos drop them into the
comment section below so I can now I can
put that into the next video for you ok
without further ado I'm gonna pop my
glasses on and we're gonna take a look
at the ear wax removal from today here we go
so this is the patient that came through
towards the end of last week
very very blocked up place I'm really
really struggling with this hearing on
both sides you can see we've got this
very dark thick type ear wax now
if you're in the u.s. this is kind of
like the middle of a Fig Newton if
you're in the UK this is the like the
inside of a fig roll so it's very sticky
quite dense granular on the inside
always a little bit more difficult to
remove this this particular consistency
of ear wax
we've got the standard size on the tube
on it now we've - you get a good grip
which it will allow us to do but it
tends to be so sticky and so thick that
when you're pulling it it tests tend to
stretch rather than pull out big big
sort of chunks luckily for this
particular patient this outer edge here
was this very sticky thick tube rather
cut hard lump behind this we did - and
pull that out because the skin is
encased around the bottom of it so what
you can see there when you're the
behinds are much much darker section
further in shows me that it's gonna be
that a little bit drier perfectly form
to the shape of the ear canal so I've
introduced a little bit of olive oil in
here just to mainly stop it from re
sticking when we detach it when you put
the olive oil in if you move the ear wax it
forms a little barrier between the ear wax
and the skin so instead when the ear wax
rest back down there on top of the skin
it doesn't stick to it it just slides
over the top so we've got a good grip on
the right-hand side of this ear wax we get
another bit of a wiggle to detach it
from from the piece behind so we've
managed to do that and then when you
look now you'll see there's a more
prominent piece to the right-hand side
of the ear canal so this is jetting forward
a lot more so I'm getting a grip on that
and just try to move the ear wax now take a
look at the ear wax as it moves what we're
looking for at the moment we're only
moving the right side we'll know when
it's fully detached because the whole
thing will start to rock if you look in
there did you see that then the whole
thing moved so that's the kind of that's
what we're looking for that shows where
you can see now we've managed to get a
grip in the centre we're looking for a
good suction grip now to slide this don't
forget that all Olive oil gonna be sat
underneath it
lowering it to slide across the skin a
lot better it's gonna pull this forwards
but I can see but based on the the ear
ear canal entrance that this ear wax is not
going to come out of that ear canal entrance
so what we're gonna have to do is break
a few more pieces off and if I can bring
it forward enough we can get behind it
down with the oval Jobson horn there we
are
which is quite showed you a couple of
videos ago so you've got the oval Jobson
horn in there Were aiming
the top of the ear wax we're able to get the
Jobson over the top drop it behind and
pull it food through which is what we've
done there but don't forget this ear waxy a
little bit more kind of not crumbly but
it breaks apart a lot more easily
there's not a great deal of kind of
structure to it so what has happened
there is the jobs and horns got it now
she's sheared a section off the front so
now we're going to use the Jobson horn
again to get in and just take away this
section that was hanging on the
right-hand side there we go that's just
come away now now what you'll see now is
there's no gap okay so we can't push the
Jobson horn above it because what would
happen is it would catch on the ear wax
actually push it further in we've just
pulled it out so we're going to use the
centre section the ear wax dig in which is
what we're doing there now and bring
that forwards we're using the structure
of the ear wax against itself if you like so
we're kind of pushing so it's soft let's
push into and then just very steadily
and gently pulling back this way that's
gonna slide the block forwards I'm
trying to wedge it into a portion of the
ear canal so we can really get behind
then and drying it out there we go
that's coming nicely you can see in this
next section I was is quite close to the
entrance we're just going to go behind
that section there we I've got behind
their nose looking Goods coming away
nicely slowed it down a little bit here
just so we can show this coming out
still going still going there we are now
we're free look at that it was touring
down a fairway and you why don't we just
talked about that the st. Bart's fog you
can imagine trying to use that st.
Bart's photo to get behind that you love
no traps it just wouldn't get down far
enough we've got some remnants left
really close to the eardrum always
difficult this type of removal when we
get closer to the drum you know it's
looking really dry look at how that's
bending and flexing like if that was
much looser type of ear wax and that would
come we really nice to be you could see
it just how do we fold it over to get
that out and now we've got a lot in the
top portion of the ear canal so imagine this
is the roof of the you can I saw up here
just in front of the eardrum so just
want to clear some of that away you can
see it starts from way down close to the
camera so if we just start
Chipping some of this back there we go
that's taking that front section away
you can see it's much lighter in colour
as this dry skin type type of remnants
of debris in there very slow this is the
fine end remember see we saw that last
last video very very tiny gently peeling
that away
imagine you eardrum just for reference
is like the tip of your little finger
okay so that's the kind of size you're
looking at so it gives you some
appreciation as to your the space we're
working in as far as this little bit of
skin Deborah's concerned just get this
last little bit down here here we are
starting to pull away it's really
sensitive as well down here we're always
really careful with a patient I think
most patients won't tolerate you taking
whacks away that deeply for very long so
actually this is the same part I think
I've just showed you the same bit twice
sorry about that
oops it's that before silver ignore that
the last bit it was like deja vu so
we'll go back and take a little bit done
four billion so we're just going to go
back in now here we are you can see this
just a little bit here to the left hand
ear canal I'm really sorry about that guys
let me start yet today and just peel
this a little bit away here
there we go that's come away really
nicely there you can see that just like
a little bit of dry skin was left in
there whoops just dropped off here look
at the entrance we'll just clear that
away for you I just blocked the end of
the section with a fine end obviously
you saw from a couple of videos ago it's
a very very narrow aperture at the end
if you've got sort of a hard piece or a
piece of dry skin something that just
flicks up and just covers the end that
it was a few problems but you can see
that your drums looking a lot better
there now much much healthier so this is
now the same patient but their second
ear
fingers crossed with one double edit
some of this as well but you can see
we've got a very very thick layer of ear wax
on the outer part of the ear canal a
little bit stuck to the right and left
ear canal wallet just at the entrance as
well lift off from the bottom here same
consistency you know same textures there
at the bottom within this type of ear wax
really slowly pulling this away well
thank you to all our new subscribers as
well we have last time I checked we're
about 50 subscribers of 250,000 which is
epic so if you haven't subscribed
already and you don't mind doing so that
would be absolutely fab thank you so
much yeah you can see it's not really
budging deep we've got this little gap
at the top so we're gonna use that
almost Jobson horn in there again there
we are just throwing it over the top
there pulling this forwards just gonna
get behind I'm aiming to try and bring
this whole section down so what you're
not the said of doing is as I'm pushing
the Jobson horn in I may even for the
right-hand side of the ear wax and as I'm
pushing
I'm kind of moving the Jobson horn down
the ear canal wall slightly just try to
break the the adhesion there on that on
that side you see it's still a lot in
there though just try to get behind it
you'll know sometimes if you've got if
you've got a good a good grip on it
because you'll you'll just get the feel
that the whole thing is but when you
actually see the dent they're made by
the Jobson horn aiming on this or it'll
almost see a flick then what means we've
got a good grip then the whole you can
see now that ear wax is much much closer at
the camera wheel okay we using the trick
of digging into the scent of the ear wax to
try and bring this forwards a little bit
more just so I can try and get the job
so it's not quite enough room just to
get behind it see how I'm working down
that right ear canal wall again there we go
very dark ear wax coming away still taking
bits away every time but we're looking
to try and get this one piece we know
it's it's all bound together if we can
work down this right so it'll collapse
that in and we might be able to get a
good grip see it's just pulling along
the side of it it's not quite getting
the grip we need there we go that right
pieces just popped out
let's take a look behind that we can see
we got more in there's a really
annoying piece on the left-hand side so
we're just gonna shift that along there
we go we've moved that piece now see how
the whole thing that was wedged in the
in the entrance to the ear canal so we're
just gonna try and get behind that
almost there that's so close we're
almost there
there we go big you saw that piece
coming away and then that rear section I
must look at it look at that check that
last deeper dry a darker section came
away then a little bit of dry skin I'm
struggling to pick this up so there we
go this they would pick it up with a
suction tube look how long that is there
you go you can see why we were
struggling to pull that forward luckily
it didn't go down to the utilise it on
the other side so this is what we remove
so that's four just on the four inches
there
and just under 10 centimetres look at
those two pieces there though that your
these were the the two larger pieces we
took out look at all the debris that was
sat around that you've got a piece there
around about the 3/4 of an inch mark
that's white in colour so that's that
that sort of skin debris we can see
there but yeah you're really really
drying out oh sorry I forgot to flip
back to that I really really drying out
I'm plugging that a you can a lap you
can see it's really kind of bound it all
together it's really stuck to the ear canal
walls and you've got these long plugs in
there which are really difficult to
train them a move around especially when
you get the grip on them with the
suction what are you doing is you you've
got a certain amount of wiggle so you
can go up down left right a little bit
but then when you've got these really
long plugs in there the rear end of that
plug is still sticking to the ear canal
walls you'll get some movement to the
front or the rear ends but not difficult
that's why we switch somebody's we put
the Jobson horn in we start taking those
those little bits away it really helps
to get behind that ear wax and get the
momentum you needed to see it by the way
ah
I hope you enjoy guys as much as I did
as you could tell a little big saying
this was the end but if there is
anything that you guys would like to see
in the videos obviously I know we've
changed the format a little bit recently
and that seems to be gone down quite
well which which I thank you for feeding
back on that for me but if there's
anything you'd like me to do as far as
the ear wax was really in particular you
want to see let me know and we will by
popping into the comment section below
and we'll get that done for you next
video is on Wednesday so I shall see you
there as always guys take care see what
9 p.m. on Wednesday have a good week