hi everybody this is Rhys Barber from
audiology associates thank you very much
watch our ear wax removal video and
you gave us some fantastic suggestions
about the types of videos that you want
to the see over over the next couple of
weeks so we went with the top 10 so
these are our personal favourite top 10
ear wax extractions from our channel
they're three hundred and twenty some
odd to choose from so it was quite a
tough choice to narrow it down to ten
but these are our 10 favourite so there
were lots of jest suggestions that came
through one was that could I show you
this so this is the big ear that
everyone sees behind the introduction so
basically this is a model of the ear
ear canal so what we're going to be doing
today this particular extracting of the
sea was episode 62 which was a really
really difficult extraction to do mainly
because the ear wax was located right down
here right against the eardrum okay so
right down there and into this little
valley that de P is just in front of the
ear drum there as well so we had a lot
of very very dry skin and ear wax down here
the needed removing what complicated
matters a little bit was the ear canal
was very narrow which meant we couldn't
accommodate the standard size tools in
there so it was a really really good
extraction to to watch so without
further ado we'll pop the public
extraction on and I'll talk you through
it as we're going along I'll pop my
glass soon as well so what you can see
here is the entrance to the ear canal
you can see that very very deep section
of dry dark coloured ear wax all on the left
hand side of the ear drum and there's a
little bit of dry skin around there so
this is the standard size on the tube
you just saw me try to put in there and
you can see that it just wouldn't
accommodate the you can I wasn't big
enough to accommodate both the endoscope
and these all in the tube so we've got
the fine end on here
we can see we're just some tees away and
a little bit of dry skin just sitting
down in front of the front of the ear
drum there they really stand and lift up
and pull into the into the suction when
you're using the smaller fine end as we
are here what you'll see is that you
can't really get a strong suction grip
because it's such a fine aperture on the
end so you do tend to pull a little tiny
pieces so it's great for moving things
around
not ideal for taking away harder ear wax but
because of the size of the kid I'll wear
them to go with that you can see
actually as we're pushing as or as as
we're pulling the ear wax across from left
to right train unpeel it there's a
little bit of flexion in the eardrum so
that tells me that this ear wax is sitting
right down on top of that eardrum so
it's difficult when the entrance is so
narrow to get the angle you need to get
into into specific spots don't forget if
you look at the tip of your little
finger that's as wide as your eardrum
would be so what you can get a rough
idea of how small that space is now as
we get a grip here keep an eye on this
or the right hand side I do put a
pointer on here in a second just a point
that might be might be a bit further in
because you can actually see the whole
thing starting to rock and to push
against the eardrum when when we're
actually moving it there we go so keep
an eye on that section watch now as we
pull from this left side to the right
side watch as the ear wax tilts and starts
to sort of press against the eardrum
slightly keep an eye on it there see the
whole thing just GS pushing no forget
there is obviously the wrist flexion in
the eardrum itself because that needs to
vibrate to be able to pull this out this
patient I remember vividly actually it
was a lovely lady she came through she'd
used q-tips to train clear here which is
and gone very very deep of them which is
what pushed this down we've got that
classic q-tip use shape as well that
much deeper hard recess section and then
this thin layer all around the outside
edge so I'm trying here using that
limited section with the with the fine
end to pull across you can see would
just stand a loosen a little bit there
now see how it's starting to break away
we're getting that peel just coming away
a little bit sorry was going really
close to the screen so I could see
uh-huh but if you if we kind of peel it
it will just see it just on the fold
away there
do you see the whole thing move then as
we touch to it that whole section so
that layer across the bottom up the left
and across to the top is one big section
of ear wax there just slowly trying to pull
this away very very just teasing it out
we can start to see the skin of the
intern
coming through behind that we've got a
grip I'm holding the suction on their
train to gain a bit of a suction grip if
you hold the suction tube in place
sometimes you can get a really good grip
on there I mean we talk to a different
section now Trading flattop see we're
pulling to look at the dry skin there we
are look at it fold down there from that
top left corner there we go the whole
thing we could tell the whole thing was
just hatched together this is a layer of
dead dry skin so without ear wax or straight
it's dried on top of that skin there so
it just means that when we pull it that
the whole thing is coming down really
trying to pull this down normally we go
in here now with a set of crocodile
forceps because of the small opening to
the ear canal they I can't accommodate
the forceps and the endoscope in there
at the same time but again a good grip
there we asked it we pulled that top
section there we are just it's starting
to move there we go can you see it start
a tease down the ear canal there we go
pulling it across really trying to
loosen it as much as we can hold in that
suction again look it's just pulled a
little bit of that ear wax through that dry
skin it hasn't pulled it all out there
we go what I'm really trying to pull
down not only we wiggle a lot more but
don't forget this is right against the
you John we can't wiggle it too much
we've run the risk of damaging the
eardrum so we have to do this and sort
of make steady movements pulling it
across train doing for a deeper section
they would go trying to pull that across
as well it's really wedged in there it
broken some of that some of that skin
away let's take a look now to see if we
can get Oh nearly there you can see it
there we go there do you see that
movement ends it pulled across it came
out to the gap it's pulled down it says
it's just more from a little Valley go
into the outer part of the ear canal
now the small fine end is not going to
be able to pull out of the UK now hasn't
got enough suction grip on it so we're
just going to switch back to the stuff
look at the size of the standards over
to compared to the ear canal you can see
how small that entrance was there took
some dry skin the way got another block
of ear wax but
that one maybe that's just there we go
just start to come through if we take a
look
there we go you know we can see we've
got this layer of dead skin sitting at
the perspective group also keep trying
to see past all of the other I got this
layer of dry skin at the bottom of the
ear canal they're working very close to it
trying to lift this again see it's not
really lifting very well there if we
switch across now we might Peel
section from the left side so if we go
back in on the left side and lift look
what happens you can see the whole thing
started a lift there we go start the
peel away hey look at that look at that
chunk dry skin anyway look how much was
down in there that whole layer you know
that whole section was named flat and
there's this dead skin layer behind
you've got a very tiny little chunk of
ear wax just sitting on the brow of that
that little valley there so I'll just
carry that that that's actually looks
like dry skin the ear wax that one and won't
be the cracking you can see we've got
these are actually little tiny hairs or
fibres off cotton ball balls I got more
bud q-tips so whatever strange tree is
really difficult to remove those when
you look at suction us all it does is
just kind of pulls them in but doesn't
really remove them so they just kind of
sit in this they're really hard to get
rid of you can see the dolls need a
little red spot there with where the ear wax
to be rubbing back and forth this is
what we removed so you can see they were
tiny pieces with a flap of dead skin
though around about the one centimetre
mark and you see how much of that was
actually attached to the ear canal wall and
bent and around into that Valley as well
the much harder very very dark pieces
certainly to the left-hand side as well
that very dark chunk there with this
piece of sort of flap of dry skin that's
come away from it so you can see just
how much was rest and down again
Eardrum and how it would have been
really uncomfortable for the patient who
may have had Barnaby bark at the back
grab that but you get you get this it
was really uncomfortable and deep in
there for that for that patient very
relieved to get rid of that very very
relieved let's go back to me a second
okay so um yeah it was all right that
was probably one of our there was one of
our earliest videos it was 62 so quite
an early video and quite a difficult one
to do and
you know we technique-wise where I
probably would have gone for that flap
of skin just at the top corner of Paul
that dough a lot sooner than we did in
this video but you know all comes with
experience at the end of the day and
thank you very much like I said for your
suggestions if you do have any other
suggestions you can think of videos
you'd like to see well carry on doing
the top tens but if you think of
anything else you'd like to see them by
all means let me know a few people
mentioned they'd like to know what goes
on kind of behind the scenes or what
goes on with us Theatre in lockdown
stuff for that mrs. B has set up an
Instagram account which I'll put a link
to in the description below we've got
lots of projects going on a house at the
moment so we kind of renovate your bits
and pieces if you want to take a look at
that you're more than welcome to that's
kind of what we're doing in the
background when we're not doing this and
we are due to reopen really soon we've
got another little the PPU coming in so
fingers crossed we're hoping for the
first week of June to reopen the clinics
because we're still on a three week
lockdown here in Wales so I hope you're
all doing well I hope you're looking
after one another and yourselves we
personally have lost people to Cove it
19 and our family and we really really
sincerely hope your your you guys are
all doing well yourselves don't forget
guys look after yourselves look after
family look after one another and I
shall see you again real soon