hi everybody this is Rhys Barber from
audiology associates thank you very much
for watching that video today we have
another bilateral erection war for you
now this gentleman's attend a clinic
with some dry earwax in both ear canal so
we looking here and just yet little so
amount of dry earwax in here so we're gonna
use a bit of microsuction to remove this
first of all this is a standard size on
the tube so you can see it's used a
little bit of olive oil just to try to
soften this up for us so we're just get
in the first section away here we go you
can see the different colour variations
and that earwax there so quite old and new
earwax together microsuctioning away you can see
we've hit some of the harder pieces of
earwax in here now just get a grip on any
leading edge we can with the the microsuction
so we have an awkward shape to
microsuctioning this is quite flat in some
places which is difficult to get so you
imagine to get a good microsuction grip on
this you need to be completely blocking
the end of the microsuction tube to get to
although the pressure to build to grab a
good grip on it when it's quite flat
with lots of leading edges like this one
is it's difficult to get a good grip on
on one piece so just taking away piece
by piece this gentleman does have an ear
nose and throat history but not with
this particular yeah I'll explain a bit
more detail when we look at the other
side now so it's still taking away these
these little pieces you can see it's
quite flat here it's gonna be difficult
to get a microsuction grip so we're going to
use the crocodile forceps just to go in
I'm just going to try and get underneath
and above the gods you get to try and
get a good grip on it just pulling a
little bit broke off there so it's
knowing the older part of the ear canal
so we're just gonna trying another grip
on this little piece broke off see
difficulty with using crocodile forceps
is little bits break off sometimes so
I'm just going to use because it's on
the outer part of the ear canal we're
just gonna groom of the Jobson horn just
to get behind excuse me sorry behind it
manoeuvre it forwards
here we are it's out of the ear canal now I
didn't want to cover that gap so just
use the section just to go Griffon it to
take it out so there we are that's the
seal flat that pieces looks like a
little kind of panty shape there's the
ear drum there you can see so they're
clear that earwax away a couple of dots in
here's we're just going to go in with a
slightly smaller microsuction tube just a
whole wrap dry skin there that's gone
it's not as important to take away these
little bits it's it's not going to cause
any issue you're having these little
tiny pieces of earwax in here just taking
away a couple of the extra little pieces
you see a little here just getting into
the bottom of the view there yeah lovely
shiny you drum your lovely and healthy
okay
now this year there's a more complicated
history with this well you can see were
lots of dry earwax in here little bits of
skin can't really see the eardrum in
there what I thought was the eardrum the
top left hand corner was just a
reflective bit of skin so this earwax much
much tougher on it so you can see we're
just trying to lift it with the the
Jobson horn here
much drier pieces of earwax and dried up
pieces of skin so we're going to opt to
use the crocodile forceps the difficulty
with this earwax is it's so dry that is
just you can see it's just starting to
break away in little pieces this is not
gonna be a quick extraction guys this is
going to take quite a while and you can
see as soon as I'm gonna grip on it it's
just taking these little tiny bits away
now the reason I haven't gone in with
the Jobson horn just yet is I can see
that all of this is moving in
one large piece so as you get a grip on
it you'll see the whole thing is moving
or cable as hard as I'm pulling on
pulling at it with the crocodile forceps
the skin the dry skin is holding this in
place so they can you see the whole
thing is moving so if I try and put a
Jobson horn in here that's all I'm gonna
do I could try and drag it down the
ear canal but that's all that's going to do
is it's going to be pulling against the
dry skin from behind so I'm gonna have
to push so hard against that earwax to try
and pull out I could risk damaging the
ear canal itself or causing some
irritation or bleeding in here so I'm
opting to stick with the crocodile
forceps and just as painstakingly as I
can
take all these pieces away so we've got
we've got a quite a large amount of of
dead dry skin behind all this which is
just what's holding all of this in but
there is so much in here it's gonna be
quite a frustrating watch because you're
gonna get lots of these little pieces
breaking away they're just lifting with
a crocodile forceps
thank you guys I'm getting a grip on it
you can see as I'm trying to push into
it to get a good grip of the crocodile
forceps oh you can see the whole thing
slides backwards
so every time I try and get a grip on it
the whole thing is moving backwards and
as I'm pulling it the whole thing is
being held together that's why we're
just breaking these little small pieces
away and we're starting to run out of
places to get grips on here with the
crocodile forceps yeah we just see we've
got a bit of a leading edge there now
people ask me you're white why are you
going in coming out going in coming out
you can see the end of the crocodile
forceps that they're quite blunt and as
we're taking it away what we're getting
is a grip on a piece of ear wax and as it
pulls away or just try to wiggle it out
it's not coming you can see that you get
these bits of ear wax sandwiched in between
and the grips on the crocodile forceps
well because the end is so blunt I need
a really good idea of where the end of
these are so I can clamp either side of
this ear wax if it's all gunked up inside
with with ear wax and skin I'm not going to
be able to tell where that grip is so
I'm just going to use the microsuction now
just to triangle other leading edge to
work on with the crocodile forceps it's
too dry to take out with microsuction and
because the dead skin is holding this in
with such such force
microsuctions Grif is not strong enough to
pull it out so what I'm doing I was just
pulling a piece down from the ear canal wall
so I can try and get a grip on it that's
all frustrating just keeps breaking away
just to try and get a grip on it so we
can keep taking it away thank you to
everybody who wished us the best with
the new clinic launch that's officially
opening to patients next a week tomorrow
so that's the 27th of Feb
so if my videos do become a little bit
more sporadic over the next week or so
it's just because I'm working so hard
and getting all up and running and might
not have time to voice the videos over
but I will keep trying to put one up at
least every other day for you guys so
just starting to get some larger pieces
moving down the ear canal now as well you
can see it's just really frustrating to
try and get grips around this ear wax
because you think it's going to come and
it breaks another piece away so we're
still working on this no matter how much
of this we take away every time we look
in there that just seems to be more
there to take away again this is
certainly one of the more difficult ones
it's not where the ear wax is so much but
just how the ear wax is behaving because all
that skin that's in there and that the
history for this on this nice larger
piece coming away there the history for
this gentleman he had issues with the
perforation Jersey air drum when he was
here when he was a youngster and he's
been noticing reduced hearing for a
little while but not really done
anything
I presumed it was due to the fact he had
this perforation when he was younger so
not really go along to the GP to have a
look in here so this is probably the
first time I was looked in this year for
a good number of years and what we have
in here is just this whole debris skin
ear wax buildup and it's this is quite a few
years worth we're taking over here just
manoeuvring this ear wax into a better
position so I can get a grip so I can
get basically underneath and above a
leading edge in here see it's still
coming no matter how much you look in
there there's just more and more coming
down the ear canal I managed to work a piece
to the outer section of the ear canal
now it's getting a grip
still breaking away so I'm not expecting
to see a nice lovely look in the ear
drum after what we've taken out of here
I think we give it obviously we're gonna
see a lot of scarring there we might not
even see the ear drum at all looking at
how much of this dead skin that's coming
out still manoeuvring this out it just
keeps coming
see still no obvious gaps in here there
is a bit of a leading edge I think we
can get behind it with the jabs and
horns I'm just gonna gently probe this
down now I starting to see a little bit
of light at the end of the tunnel there
now that looks like part of the ear drum
I can see behind there so you can see
all this skin and ear wax debris coming out
there you go I don't know whether you
guys have watched there was a previous
one we did but it was a long ribbon of
skin in the ear canal that got removed
I think effectively that's what's
happened here but instead of getting to
it earlier as we did with the other one
this ribbon her skin has stayed in here
and hardened and that's just caused all
of this ear wax and debris to build up
around it so we're still removing here
you can see we're still taking ear wax from
this ear canal
see how tough this is really holding
this ear wax in here it doesn't want to come
up without a fight
and still there's more in there so we're
still going another large piece of skin
and ear wax and we're still going you can
see we're pulling all this old dead skin
away now they're just using a little bit
of microsuction just to try and loosen some
more of this dead skin away trying to
manoeuvre into a better position back in
the crocodile forceps because we've got
a leading edge we can work on is it
going to come away one big piece no
doesn't look like it now
okay going back in with the jobs in Hong
so we've manoeuvred it forward slightly
so just going behind this earwax and skin
you can see it how much it's curled
around in there okay it's still coming
you can see it all just wrapped up in
here and all twist it around itself and
it's still coming
so more microsuction you can see we're
getting to that the newer kind of dead
skin in here is whiter in colour hasn't
been in there as long so we know we're
coming to the end of this now
we were just trying to work this down
the ear canal can see can you see all
pulling down in there I mean so this is
quite a few years worth just trying to
break this section away there you go
okay
and still there's more
okay now it looks like we're coming
towards the end of it there you go let's
take a look in it we've still got more
coming yeah a little bit more on the
outside edge of the ear canal there so
I'm just gonna pause you can see how
this is holding in all these layers of
skin wrapped and wrapped and wrapped
around one another and all in sort of
intertwine with the earwax so you can see
now why we were having real difficulty
getting this out of the ear canal there you
go long strips of skin looking better
the rear of this okay right so we've
removed all the debris you can see just
how messy this ear canal is what you
have here obviously this skin hasn't
been exposed twenty or anything for
quite some time there's a lot of old
dead skin and debris in here I'm just
sort of lifting the couple of these
little pieces away what you can see at
the top of the screen this little flap
is gonna working on that was just in
front of the ear drum you can see you
see that the sort of texture of the skin
that's the ear drum behind it there with
lots of this was a dry skin debris
sitting in front of it so this chap is
gonna have to take a trip to the nose
and throat Department we've cleared this
out as best we can
but I think what's left there I think
that's actually part of the actual drum
itself I think this is hardened skin of
the actual drum so I'm not gonna be able
to take this away just so gently
touching it here just trying to take
some of this extra skin away you can see
all the indentations and dimples around
here but the couple of people asked us
why and why we always show nice shiny
eardrums the majority of what we get
coming through is quite a healthy
looking drums but this is a very
unhealthy looking here ear canal you can see
this still still quite a bit of sort of
scarring and bits and pieces going on in
here so yeah trip down to country and
those and throw for this one yeah not a
great deal we can do without ear drum
just wondering really good shot but so
you could see what what we look at here
but no obvious sort of anatomical
features we disassociate with a healthy
look in the eardrum there this is
everything that came out so the first
probably about the first three
centimetres of the first a inch was the
the one year the second year was all the
rest of that debris so you can see we
took out what 15 centimetres almost six
inches and that's without what we had in
a tank there so you can see was quite a
bit in there well thanks again for
watching guys and as always comment like
share and take care guys