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
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[Music]
hi everybody this is Rhys barber from
audiology associates thank you very much
for watching our election what I do
today we have two patients in this
compilation video the first patient has
some very very deep dry and impacted
ear wax
this looks to me that could be the q-tip
used because there's a nice big dent in
the in the front end of it here and the
outside edge is there and you can see
her coming across the ear canal wall more
towards the entrance to the ear canal so you
get this kind of pushed in middle which
tends to happen a lot with cute abuse so
what we're going to do today is we need
to unstick this out edge first of all so
I'm using the standard saves on the tube
here just to try and free up the outer
edge of the ear wax pull it away from the
ear canal walls because obviously if we work
straight on the centre and try and pull
forwards this is gonna hold it in place
so we're just taking that away you see
the first bit you can see how because
this has been kind of compressed
together with what I believe is gonna be
the q-tip you can see it's kind of
squashed the ear wax together now ear wax can be
kind of what's the best way just going
off fluffy but kind of that kind of more
open texture to it whereas this now it's
got that more condensed texture somebody
in the comments said they come up with a
perfect description which it's like
fudge if I don't want something fudge as
an American thing as well but you can
it's that kind of consistency that you
get it's really kind of thick thickened
up kind of consistency so what we're
doing though is just taking all that
outer edge where you can see just
exposing the ear canal wall underneath it's
really tough all stuff this oh it's very
deep so not the most comfortable place
that were taken away from because
obviously the deep you go into the
economic most sensitive everything
becomes so and we've got to work really
close to the ear canal wall to be able to
peel it away so we're trying our best
not to touch that ear canal walls we don't
to make it and you know too
uncomfortable for the patient we've got
a nice kind of projected out bit here so
we're just grabbing that section taking
that away now some people will probably
be asking themselves well if it's that
very why you wouldn't use olive oil on
this the really simple answer for that
one is
this patient has really quite dense
cilla sort of fine hairs on the outer
part of the ear canal now I know if I go
spraying olive oil in there it's just
gonna completely coat those Cilla and
it's gonna make the view here really
really difficult to see because you
don't the want olive oil stick to those
and coat the end of the endoscopes you
don't get a particularly great view so
I'm just do as much they can without
using any olive oil you can see we've
got this kind of more hardened up
section there in the centre lots of
little tiny hairs embedded in there from
probably ear here trims just breaking
that front section away there and just
pulling that down I'll lift the ear canal
you can see lifting from the ear canal ball
there at the base yeah I know estancia
our first glimpse of the eardrum there
now pulling it of the ego so we've
detached it now from the left Corral
wall the right ear canal you can see how
much more easily know this ear wax is moving
so just trying to work this out
just getting a grip now we've got this
flat edge we can get a grip you see with
the crocodile forceps so just trying to
use the crocodile forceps to take this
out but it's just broken away in the
centre so it's a bit too soft but too
hard to sort of microsuction really
effectively but a bit too soft to get
the crocodile forceps to hold onto it
tight enough and and keep it's kind of
shaped to be able to pull it out so I'm
gonna do is bunch a lot of the ear wax in
the end of the of the microsuction tube so
really kind of jam it in there to get a
really good strong microsuction grip which is
what we've got now and then I can work
on the flatter edge look to remove it
here we go out pops and it's got a little
bit of a little bit of ear wax there at the
base of the ear canal so we'll just take
that away with a microsuction there we go you
can see the edge I'm looking nice and
healthy and there okay now this is the
second ear of the same patient you'll
be able to see from this one we've got
some you know very very impacted ear wax
really sitting on top of the eardrum we
also got this kind of white section to
the right-hand side of the ear canal just
come into view now there we go so that's
actually a piece of dry skin that's been
kind of rubbed almost like like a like a
callus kind of consistency so you get
this hardened up top layer of skin so
I'm just gonna outwork it's protruding
out a little bit so I just want to just
do a bit of gentle probing of that so
we're just gonna microsuction along that in a
second and obviously if you when you
guys watch the episode 200 you know that
we're constantly talking to the patient
the whole time so while I'm doing this
I'm always checking in you know making
sure this is not uncomfortable is this
painful at all for the patient this
patient was an absolute star he was so
good a genuinely lovely guy so he was
absolutely fine with us carrying on he
was he was at the mindset of whatever it
takes to get it out absolutely fine it's
not uncomfortable or carry on so he did
really really well they were going just
see it starting to bend away from the
ear canal wall there you can see where that
hardened up layer of skin on the top
you've got this much sort of wet newer
softer skin then underneath you can see
it there so I'm just trying to get as
much little way from that as I can
before we look at taking this out really
you can see it's really welded really
welded on to that ear canal wall it's it's
it's not gonna budge really easily here
just trying to gently lift using the the
edge of the microsuction tube there to remove
it now you can see the view we have here
now what we do sometimes is we get the
patient to bend their head over to the
opposing shoulder which you can see
changes the view so I can see a lot more
at the top of the ear canal now so the
patient if you imagine is leaning their
head over to that towards their shoulder
which then allows me to work on that top
section and you can see when I grab them
much more like here getting this ear wax
away so we've got a nice big leading
edge now so
the crocodile forceps are gonna come up
with this one just pinching pulling
forward ever so gently there you go and
then unfortunately a bit broke away but
what we're doing now is using the Jobson
horn to try and get behind this see if
we get more luck with the Jobson horn
it's this really odd Caitlyn whoops no
you push it back up this really odd
consistency of ear wax this one because it's
it's tough but a little bit brittle so
if you imagine if you like we said fudge
that fudge consistency that's what
you're looking at so it's quite solid
until you start pressing into it and it
starts breaking apart which is what's
happening here so I'm just gonna
manoeuvre the ear wax and then sometimes
we'll alter grips are going a little bit
further you go just to shoot and grab a
piece behind it but that's breaking away
sorry again with that Jobson horn there
we are now we're starting to see it move
we've pressed the side down now so we
can get behind it a little bit more
effectively move for the pop down oops
back to the camera no way through so
what you can see now there we are
there's the eardrum is that white bit of
sort of dry it's not rightly said like a
where the dry skin was so this is what
we have here in centimetres and in
inches this is one and five-eighths one
and eleven sixteenths thank you very
much to Pete who sent me the inches
measurements now it's broken down so I
can actually get it right this time
so what we can see here this patient has
a big skin flap that's fallen down into
the ear canal so are really big so long
skin blockage so what we're gonna use
for this one is the standard size on the
tube just to get a grip on the outer
section here this is just gonna loosen
it from the ear canal wall not always the
easiest thing to take away with microsuction
skin debris just because it's it's noisy
so you get that really though squeaking
sound coming through switch we try and
kind of manoeuvre it and put it into a
better position so that we can use a
different tool than to get out in this
case we got a nice
pocket of skin so we're going to use the
crocodile forceps just to get a grip on
that here we go so you can see just
putting a bit of tension on it try not
to pull it too hard we don't like the
tear but unfortunately there it goes so
it tore the outer section so we're going
to go aim a little bit further in get a
nice good grip on this piece Jen
terminal there we go and out he pops you
can see just how wide that skin flap was
so that was completely enclosing the ear
ear canal so there's the ear drum they're
looking nice and healthy
I sit in centimetres I see easy that's
an inch there you go that's easy one
you very much for watching our video
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always guys until the next time take
care