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 subscribing
hi everybody this is Rhys barber from audiology associates thank you very much
watching our ear wax removal video today this was a bit of an unusual one for us
normally we can get ear wax out on the first visit but I've had lots of people asking
is there ever a time you can't get ear wax out so this is the this is a patient
we've had through recently who had very very impacted ear wax basically they'd
been not hearing very well for a little while used q-tips to try and clear
their ears they thrown every kind of lotion and potion and there to try and
clear this out and then use q-tips again to jam it all in so what we've got is a
patient that's got a very sore ear very deep and impacted ear wax so we're using
the standard size zoellner tube to remove this now what you can see is the
outer section of ear wax is very very soft because that's been in contact with all
the drops the olive oil the sodium bicarbonate the hydrogen peroxide
everything basically they've thrown in there has come into contact with this
front section of ear wax but the difficulty is when you take that away what you have
then behind it is a very very deep hardened thick sticky plug of ear wax
so what we're doing here is using the standard size zoellner tube to try and
release this out if we can and what you can see is as we're getting a grip on
the ear wax it's just bending and flexing so we and
because it's so deep in the ear canal and because it's quite uncomfortable in
there for the patient because this is putting pressure on the ear canal walls
around all sides perfectly form to the shape of your ear canal so really difficult
really really difficult to remove you can see at the top there there's no gap
so just really wedged in there so where we would normally wiggle this back and
forth to remove the ear wax we can't wiggle it we can't move it too much
because the patient is in is in quite a bit of discomfort not due to what we're
doing with the suction but just because it's been rubbing back and forth inside
that ear canal for some time it just means it's we then are restricted with
we can use on the ear wax so this is one that beat us we could not get this out
in one visit so this is the reason I wanted to show you this one because
everyone when you see the videos and we edit them together you know it's there
are occasions when we just can't do it and we have to get the patient back in
so I thought I'd show you one of those so what we have here is break it we've
broken some of the dry skin around the outside edge away and what you'll see in
a second is as we start taking some of the ear wax from the left ear canal wall you'll
see a deeper redness to the ear canal now that's where it's been rubbing that's
why it's uncomfortable for this patient it's been really sore in there so we
have to be mindful of that red irritated spot of the ear canal there so we're just
trying to maneuver this through I'm trying to avoid using the Jobson horn as
much as I can only because this is quite deep I want to use it really as a last
resort because it can't no the patient's already feeling quite uncomfortable we
we do have to use it in a second just is just to try and shift it along a little
bit but you can see just how thick and
sticky and blocked this ear canal is poor patient hasn't be able to hear for
a long time and it they've got really frustrated with it I'm trying to avoid
the left side as much as I possibly can so I'm trying to work on the base of the
ear wax to lift it just try and find any purchase on this ear wax to try and maneuver
it lift it and just get it moving out of this ear canal but as you can see it is
firmly wedged in there you can see that redness again there to the
left-hand side we are breaking little tiny pieces off all the time so we are
chipping into the ear wax but it's it's not really budging it's not really moving at
all you can see us all we're doing really is just smoothing this ear wax so jobson
horne going to go in here you can see more redness there as I
start pushing this jobson horn down you can see we can't get behind it it's
it's really difficult we're just pushing a groove into the center of the ear wax so
it's not really getting the grip now don't forget the eardrum is it's
probably not far behind this ear wax so we can't just go pushing over the top to to
kind of get in there because we could run the risk of perforated eardrum so
I've just introduced a little bit of olive oil sometimes it will help to
lubricate the ear canal wall and it will slide a little bit more easily do you
can see us thats all its done is just pool at the base of the ear wax it's not really
made that much of a difference during this procedure obviously because this
was a it was already uncomfortable for the patient and came into clinic we're
checking in with a patient all the time asking how they're feeling you know and
fairplay he did say you know just I don't care what it feels like just get
it out but also we do have a duty of care to that patient we can't just go
sort of blindly digging around in here you can see it's just denting it's not
really taking away so I'm just trying to as best I can peel it from the ear canal
walls because that's what I'm carrying it in at the moment is that is the
sticky nature of this ear wax stuck all over the ear canal wall
little hairs have got a bit of olive oil here's a little bit of olive
oil and that's what the blurring you can see on the screen is they're trying
to maneuver it down from the top or trying to roll the ear wax just using any
kind of method really to try and get this moving but patience does such a
good job of really wedging this in the ear canal it's really really hard you
can see we're just trying to get into the ear wax but that's all we're going to
end up doing is pushing it further against the drum you can see the redness
there to the left ear canal wall now we've uncovered that a little bit more
I try and pinch some of this out of the crocodile forceps this is the people ask
what's the worst type of ear wax remove this for me personally is my least favorite
type of ear wax to remove it's very thick very sticky which means that you don't
get a great grip on it with the with the suction tube you can't it's not solid
enough to hold on to with the crocodile forceps and it's just so pliable that
when you put a Jobson horn into it just dents it rather than pulls it out so
it's a really tough one it's a really tough kind of ear wax remove this is this is
one of the hardest and most difficult ones to take away so we're just holding
the suction tube on the base there allowing the the pressure from the
suction tube to build on the ear wax itself which allows us to get a slightly firmer
grip to see if we can just pull this out
you can see it's starting to lift a little bit
but it looks as all this pieces is quite long so it's not really sometimes if
it's a short piece of ear wax as you lift from the base you'll pull the bottom out
and you'll turn the ear wax and it will start to work its way up to the ear canal
but what we can see here is it's just not really it's not really playing ball
so quite dry thing all sticky ear wax okay so what we asked the gentrleman to do was go away
for a week or you like so olive oil for a week and come back and see us so this
is one week later so you can see the redness is subsided to left hand side of
the ear canal gentleman's feeling they're hearing a little bit better so we're
just using the standard size zoellner tube again and if you look at the difference
just using a week's worth of olive oil in this ear has made to this ear wax
it's not a sticky so it's sliding across the ear canal walls a little bit better it's
not as tacky and it's not as thick so it's really started to loosen and break
this ear wax into pieces so sometimes you know it is worth going away oiling it
coming back you've always got to be conscious of patient comfort and you've
always got to do better best best practice for your patient if you feel
that you cannot you could've carried on working on that ear wax
for you know for a while longer but you would have run the risk of perforation
that eardrum you're better off letting the patient go
away oil for a week and you can see the difference it makes then you can see
it's really starting to crumble down or break away in layers now rather than
that thick tacky nature you saw to the ear wax before a little bit of hair embedded
in there as well so just working their way out and then getting to the end of
this now so you can see we're able to now roll this ear wax it's come towards the
outer part of the ear canal a little bit as well which gives us a bit more room
to maneuver that redness and irritation has subsided the gentleman said that
subside of the day after so because we'd moved the ear wax away from
area that was rubbing it meant that it wasn't causing so much discomfort and
then what we'll see in a second is the work starting to move out they way I can
see it coming forwards now to the entrance of the ear canal here we are
getting a nice big chunk there and there we are you can see the redness is gone
the eardrum looks really healthy much much better so this is what we removed
so this is what was plugged really deep in that canal that's in centimeters
and inches
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always guys until the next time take care