hi everybody this is rhys barber from
audiology associates thanks for watching
that ear wax removal video today
so in this video we've got a patient
feeling very blocked up now
in this week's videos we've had skin
plugs we've got dry ear wax
now this is a much softer type of ear
ear wax it forms almost
a treacle type consistency so very
thick very sticky type ear wax here and
you can see we've got the standard size
Zoellner tube on top of this
and we're gently probing the outside
part of this ear wax
which is then taking the surface much
softer layer off
until we can get to a slightly harder
layer underneath in which case we can
get a much better
suction grip on there to be able to pull
this out then
so what you can see us doing here is
just slowly taking away all the much
much softer ear wax
now with this more treacle
softer consistency a lot of this ends up
inside the suction
tank but we will get to the slightly
harder bits of ear wax which are sitting just
a little bit
further in and hopefully be able to get
a grip and take those out in a sec
excuse me in a second for you
there we are just working our way around
the outside edge now with
this particular consistency
it is very sticky so we end up with it
sticking to the canal walls
really well so the first thing
we're going to need to try and do is
just dislodge it from the canal wall and
you'll see now at the moment that's all
you can see is ear wax
but you'll start to see a little glimpse
of that pink skin underneath as we start
to take it away from this edge
you can see it's pulling away from the
right hand side here and you can see
a little bit of that
canal wall skin being exposed so now
switching over to the left side doing
the same there
top bottom just basically just trying
to
work our way around the outside edge of
it and hopefully trying to to loosen
this up
now we could pop a little bit of olive
oil in here as well now that would also
help to make it a bit less
sticky
we tend to do that normally once we've
got it moving sometimes just because it
stops it from re-sticking to the canal
wall then
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that's my plug done so you can see we've
got a little bit of olive oil in here
now
just around the outside edge just to
loosen this you can see it makes
that ear wax just a little bit softer a bit
less
sticky so we're starting to see it
pulling in
on the corners here a little bit
collapsing into the centre
which is going to take this leading edge
off the canal wall here
painstaking procedure these ones when
you've got much
harder pieces of ear wax you tend to go in
grab the piece of ear wax
take it out so it's a much quicker
procedure unless it's completely utterly
choker block in there
but with these much more softer and
clay type and
treacle type ear waxes like we've got in
this particular video
it does take that a little bit longer
it's a lot more preparation work
dislodging it before you can get a good
pull on one of the plugs then but now
you can see we're
starting to get a little bit of movement
to this ear wax it's
just starting this shimmying back and
forth a little bit
as we get a grip on it there's a piece
of dry skin there to the left side so
we're just gonna get rid of that to stop
it flicking up in front of the suction
there we are you can see this slightly
deeper colour here at the top
slightly harder plug here
a little bit of movement if you keep an
eye on that top left corner you can see
just how much this is moving now as we
get a grip on it
there we are coming away from the edge
now very slow
roll down the canal
you've got to be careful you've got to
keep it moving and don't let it settle
too long in one position because it'll
just re-stick to that canal wall
so you can see i've pulled that one side
along now we're changing sides
i'm moving and again now just to try and
get it moving again
you want to move it away from the canal
but not too much that you squish it
against the opposing canal wall so i've
popped a bit more olive oil in here now
now we've got it moving a little bit
more we don't want it sticking to that
canal wall so we're just going to use
this
tube just around the outside edge and
you'll see that movement
really starting now with the oil coating
the canal wall
as that ear wax moves along it's not going
to re-stick there it's going to keep
sliding
there you go as you can see here it's
really got a bit of movement to it now
you can see why this patient was really
struggling with their hearing because
this
has formed a perfect seal it's
actually stuck all the way around the
canal wall so
you imagine having your fingers stuck in
your ear and not being able to hear very
well that's the kind of thing that
we're going to get with this type of
plug
moving left to right here again
working back on this right side you can
see it start to inch its way
down towards the entrance of the canal
now we know we're not going to get this
out it's going to be too big to to fit
up the canal so we're going to go in
with the jobson horn now
just sneaking over the top here
but look at the consistency can you see
it at first glance it looks quite thick
but it's actually quite a thin more
runny type ear wax that's in the centre of
this
and there'll probably be a harder husk
around the outside edge
not ideal for the jobson horn because
what you can see here is it just forms a
channel so as you try and get this away
the jobson horne works fantastically well
if you've got a hard piece of ear wax you
can get behind and use the integrity of
the ear wax to pull it out
but when you've got this much softer
material as we've got here
what you tend to find is the jobson horn
just plows a divot
straight through the middle of it and
takes it away
so we have to again go in as we're
doing here with the suction tube
just to mop up and unstick from
the canal wall again
because when the jobson Horne does go in it
presses down against the canal wall and
we know sticky this ear wax is
the olive oil will help but if you push
it too hard it'll disperse the oil and
stick to the skin underneath
so we've just got the suction tube in
here now standard size zoellner tube again
just trying to lift away from the
outside edges here
and now we've got it all bunched into a
little ball again we can go back over
the top let's see if we can get a big
chunk of this out with the
jobson horn it's starting to pull
through there we go
out that pops there we are you can just
get over the next section
and draw this section down as well you
can see it's all coming away by
instalments here
really nice big chunk again let's
have a look behind that imagine there's
still a little bit yeah there it is
still left in there
so we'll just tidy up around the outside
edge here we've got another few chunky
bits to come away
and then we can have a good look behind
that initial ear wax blockage just to see if
there's anything hiding a bit further in
just down towards the eardrum
yeah you can see that section is stuck
to this right hand canal wall
so we're just going to peel this away it
goes down quite a way so i'm hoping if
we can peel this front section it's
going to draw that
that base section a little bit further
that deeper in section away with it
there we go it's brought it all towards
the front you can really see it coming
away now
very blocked ear canal
luckily as we're pulling this it's
the stickiness of the ear wax is drawing
this deeper sections forwards as well
that's a nice nice big piece of ear wax
there
there we are there's the eardrum looking
nice and healthy
really squeaky clean ear canal there so
obviously it points up to the left hand
side so we've got a left sided
the ear canal then this is
what removed so we've got four
centimeters worth of ear wax that's without
what got sucked into the into the
tank so
an inch and a half there but you can see
this really sticky sticky type ear wax
always a difficult one to remove this
one but patient very very relieved to
get that out to there yet
as you can imagine i've been blocked up
on one side i find a lot of patients
struggle a little bit more being blocked
up on one side they do it being blocked
up on both because they can constantly
tell the difference between the two
well guys it is friday so basically
have a lovely weekend look after
yourselves look after one another
also look after your ears have a great
weekend
and i shall see you again on monday bye
everyone