hi everybody this is rhys barber from
audiology associates thanks very much
for watching our ear wax removal
compilation video today
as you can see this first patient here
has some very sticky
skin and ear wax all mixed together here so
a nice quick one to start us off
tonight
so what you'll see here we've got the
standard size zoellner tube in there we're
just popping this on top of that little
bit of skin that's just a little bit
further in
and as we draw this out you'll see the
skin starts to unwrap from around this
ear wax plug
and just starts to pull forwards we can
get a really good grip on this now
with the suction tube feeding it all
into the end to maintain that nice
strong suction grip
a little bit of a wiggle now as we work
this down the ear canal you can see that
plug starting to come away
and all that skin that's been wrapped
around it there so it's really hardened
up skin
but we take a look behind that lovely
perfectly clear ear canal
good eardrum there looks a little bit
gray you can see we're missing our light
reflex there as well
so it would normally indicate to me that
the pressure behind the eardrum isn't
quite the same as the outside air
pressure
which just sometimes can can
make that light reflex disappear
so this is what we removed a little plug
today so half an inch
just over a centimetre there but it's
mostly skin wrapped around this this
hard ear wax layer in the middle
thank you to everyone who's been
wishing taylor good luck this week
his training has gone fantastically well
he's doing really really well of him
so he's back with us though next
week and we're going to carry on our
training a little bit longer next week
so you if you could bear with me just
for another week with the videos guys
that would be fantastic
so this really lovely gent came through
he's quite a regular patient of ours
he suffers with a very dry ear wax
so dry skin dry ear wax ear canal walls just
a little bit on the aggravated side you
can see it looks a little bit pink and
maybe a little puffy the entrance to the
ear canal is quite narrow here
so we've got the
suction tube in there just manoeuvring
this first section but it's not going to
budge so we're going to go in with the
jobson horn
and we're just going to pop over the top
and roll this hard piece of
skin and ear wax on the outside edge the
reason the ear wax goes so hard this patient
suffers a lot with dry skin in the
ear canal now
you know from previous videos we talk
about you producing an oil from
from the glands on the outer third of
the ear canal which the ear wax
absorbs so it stays nice and soft now
some people don't produce those oils or
certainly not as much of it and that's
when the skin becomes really dry
but you can see how this would have
really been affecting this patient
because there is this big plug on the
outside edge
when you look further in though the ear
ear canal isn't this shape it's more
like a letterbox shape like this
Do you have letterboxes in
america
but it's basically is it like an
oblong shape basically so as you look in
here you can see that the dry
skin and ear wax has enclosed the
top and bottom there so really sealed
this off
so we're using the standard size zoellner
tube just to loosen and try and draw
these
pieces out because they are quite dry
they're still holding on to the
ear canal walls quite firmly there as well
so we're just slowly working this up you
can see there's a little bit of
ear wax just flicking up over the front end
of the endoscope so we'll clean that off
now in a second but we've got a grip on
that piece there so let's give this a
good clean there we go
and when you take a look behind that
you can see how humid the ear canal was
if you notice that misting when we first
put the endoscope in
before the suction tube went in so
quite a quite a
warm ear canal this one as well now
sometimes there's medications that can
make patients
you know almost run a little bit hot
they get a little bit warmer
than the average patient and that can
cause
any moisture in the ear canal then to
start evaporating out
and that's the
condensation/misting is on
the endoscope camera there
so you can see we've got a good grip on
the outside edge it's pretty tough old
stuff so let's bring in the crocodile
forceps here
let's see if we can grab the edge of
this and pull it out now if it's
really brittle as it is here what will
happen is it'll just shear a little
piece off it won't bring the whole
the whole section out so we're going to
keep flicking between tools here
you could carry on just using the
suction tube but
the difficulty is with that is you're
going to be working that a lot so if you
just go in with a couple of different
tools it tends to get this out a lot
quicker
so you can see we're positioning with
the suction going in with the crocodile
forceps then just to grab that next
section and draw that down
and then reposition here again with the
suction tube
and we've got this leading edge now so
we can go in we can clip that off then
with the crocodile forceps
and we're hoping i was trying to pull
very slow
and steady backwards and we were hoping
it was going to pull this next chunk
through
you can see there's not a tremendous
amount of room in here so not enough
room to pop a jobson horn in or a saint
bart's hook here
into that gap at the top because it
would just push it further in
so i'm just going to try and grab this
outer section here's a little bit of a
lip there there we go
can you see now it managed to draw that
whole plug
forwards there so let's get a good grip
with the crocodile forceps it just came away
for this next section
let's try and move to a different spot
try and grab that bottoms and yeah it's
just taking these
just too brittle and because the
ear canal entrance is quite narrow
it's got wedged in that in that ear canal
entrance there
so that we're gonna have to use a little
bit of suction see if we can shift this
along
we've got a few loose sections there at
the bottom
but it's just you can see it's not
really budging there very well at all
so we've popped a little bit of olive
oil in here let's just see if this helps
to lubricate the ear canal helps us get a
better grip on the ear wax plug
you'll try and move everything along a
little bit there's a little bit of dry
skin there at the top so i'll take that
away
i'm trying to just get a good enough
grip here
but the surface is just a little bit
loose so when i'm getting the grip
it's it's not holding
particularly well
because the the front section is just
moving a little bit so
perfect for the rosen insert a very
thin
end on the rosen inserter here means i
can get over that layer we're just going
to try and break this up a little bit
just try and move some of these looser
sections away which is going to help us
to get
the suction tube on top of this we
just wanted to manoeuvre that and pull
and tease that apart
you can see it brought that flap down
now let's grab that with the crocodile
forceps get that out of the way
and then there we go we just got a bit
of suction there now we've taken that
loose flap away
let's see if we can get in there now
with the suction and be able to pull
this away
now the reason the rosen inserter didn't
pull this whole thing out
it's a great little tool but it's so
thin that it does tend to pull
through unless you've got a really hard
Plug
it's great i find for repositioning ear wax
it's great for the i've got a nice big
flake coming away there
it's great for repositioning ear wax it's
not ideal for pulling through because
it's not
very wide on the end but we've managed
to just loosen everything up here you
can see we've got a good grip that white
skin there underneath that plug you can
see coming away
there we go so now we've cleared that
ear canal there's a little bit of
ear wax here just inside so we'll grab that
that will pop into the suction any
second there we go
and there's a little piece just to the
one side here so let's just take that
away
there we are so you can see when you
look inside the ear canal that
there's little tiny little white
lifts eardrum looks absolutely perfect but
these little tiny white lifts all the
way around of dry skin
but this is what we removed from that
one ear canal remember how narrow that
was
so we had four and a half centimeters
that is an
inch and three quarters i would say that
is there so just
how much fitted in that ear canal
especially when you can see we could
barely fit
the standard size zoellner tube so that
little letterbox opening there you could
see in the ear canal so quite an
interesting one that one guys
oh there we are okay guys well as
always
take care of your ears take care of
yourselves take care of one another
have a lovely weekend guys me and taylor
are having a well-earned rest this
weekend ready to start back on monday
with a pretty intense week
but as always guys take care of
yourselves have a great weekend and i'll
see you on monday bye everyone