hi everybody this is Rhys Barber from
audiology associates thank you very much
for watching that you actually move all
compilation video today if you've never
come across the channel before we post
new ear wax removal videos every Monday
Wednesday and Friday at 9 p.m. UK time
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as well at the bottom so what this is
the first patient today we've got four
patients all together you can see this
patients got some really thick sticky
tape ear wax here really blocking this ear
ear canals very close to the entrance to the
ear canal as well here this is the
standard sized Zoellner tube so a few
people have asked about the spelling of
this z OE ll n ER so Zoellner tube which
is not really getting a good enough grip
so we're going to switch to the Jobson
horn here just pushing down into this
ear wax pulling it forwards you can see just
broke a big chunk off the front end
there so we're going to go back in now
with the Jobson horn you're always
aiming to get just above the top of the
ear wax and pull down and bring it forwards
towards towards the outer part of the
ear canal you can see this ear wax is
actually quite tough so it's the jobs
not as sort of getting a good grip and
in breaking a chunk away which is where
you see it flicking out to the ear canal
there look how that's rolling forwards
now can you see it's just starting to
work its way out that means we can get
to the deeper usually slightly harder
ear wax behind so we can just pull that
forwards but it's just broken that front
end away there so I see if we can get
behind this again pulling this out you
can see GS loosening it off the ear canal
walls now really trying to get a good
grip at the very back end of this ear wax
starting to turn look you see it's spun
a little bit there at the front and it's
just exposed that harder back section of
ear wax now so if we can get Jess behind
that which looks like we are we're going
to slow everything down though so you
can see this coming away we've got a
good grip in the harder ear wax behind and
as we pull that forwards you're gonna
see this whole section there you go just
popping away look at that chunk of ear wax
there so you can see just how blocked
our ear canal was a little bit of dry
skin at that white material at the back
end of the ear wax now I'm going to stop the
video
you know in a second I want to point out
this particular area here now this is
almost like the start of a blood blister
it's really aggravated the ear canal in
here so I'm gonna try and avoid that as
much as I possibly can because last
thing I want to do is pop that and
causing you bleeding in the ear canal
you can see where it's actually rubbed
raw it's taking the first layer of skin
off and you can see where this is this
little layer of blood underneath there
as well where that's all being kind of
rubbing against the ear canal wall so
I'm just gonna try and clear some of
this dead skin around it just taking
little bits and pieces off there just
trying to get some of the excess I'm
trying not to touch that section the
reason I'm leaving the section in front
of that alone is if I lift that it's
gonna make it's gonna pull straight
across the top of there the edge on
there looks nice and healthy and it's
gonna cause that bit of bleeding so you
can see this chunk here was an inch long
two and a half centimetres really deep
ready browning colours or old or ear wax
they're older ones so this is the second
patient the compilation do stay tuned
for the last patient because the last
patients got a really interesting dry
skin peel which is a really good one to
watch so stick around for that one as
well but this is the second patient now
in the compilation you can see we've got
this kind of quite hard on the outside
of this out the crust of ear wax here is
really solid but we've got this more
sticky thick ear wax and we have really
trying not to use food allergies guys
it's really hard not to do I'm gonna
have to do it this is that kind of Fig
Newton fig roll type ear wax in the middle
here okay and you've got this harder
kind of shell around the outside because
it's that sticky ear wax the standard says
on the two wasn't really getting a good
grip so we're going to use the Jobson
horn here patient jumped a little bit
there you can see the whole camera move
which is why it's really important that
we keep that bridge work so you'll
always keep in contact with a patient's
face when you're doing this so if they
move you move with them okay so it's a
really important part of the job so
we've just getting behind that section
there now at the front into that kind of
thick stickier Fig Newton type ear wax
figure also works behind it just put a
nice big chunk out there you can look at
the colour difference now you can see we
get this much much darker tape colour
this older ear wax that's in this stuck to
the base of the ear canal so very you start
off this really light colour at the front
and this much darker deeper colour at the
back there just slowly working this
section down at the front here just
broke another chunk off what I'm trying
to do is is lift that ear wax from the base
of the ear canal what I don't want to do is
dig in to the ear canal bite and scrape
along the bottom of the ear canal because
you as you can imagine that will be
really uncomfortable so what I'm going
to do now is use the standard sizes on
the tube again here just to lift off the
base of the ear canal okay so we're gonna
unstick the ear wax first so you can see
we're just peeling along the car I can
our wall sides there very very slowly
lifting this up it's getting there maybe
I would just start to see that whole
thing moving a little bit more freely
and as we're lifting we can see the
whole bottom section moving forwards so
we're just gonna get a grip on this
right-hand side portion of the ear wax here
just break that away there we go
and then we've got that slightly bigger
chunk sitting just behind it here we are
just lifting see how we're lifting it up
and bringing it forward so we were
talking about getting the jobs and home
behind it if we'd done that when it was
still flat to the base of the ear canal it
was really sticky this anyway you'd get
that moving is if you were really close
to the ear canal wall itself and as we've
said in videos before it's really
painful if you scrape the ear canal it is a
high risk of bleeding there as well
because the blood vessels are so close
to the surface because the skin is so
paper-thin so what I've done is lifted
it which is detached it from the ear canal
wall it means I can get behind it then
without running the risk of touching the
base of that ear canal there we are there's
that nice big chunk and if we take a
look behind that there's in the eardrum
looking squeaky clean a little bit of
light reflux but not much so this is
what we remove so you can see a big
chunk was to the right hand side there
so that's or just over two and a half
centimetres an inch of 1/16 there so you
can just see that was it was quite a bit
in there third patient now in this
compilation nice quick simple easy one
this one patient had really softened
this up with a lot of olive oil you can
see that it's really
about halfway down the ear canal here so the
first thing we're gonna need to do
before we can work on that central plug
it's just trying to attach some of this
outer dry or ear wax from around the outside
edge there the fact the other Wells gone
is going to really make a difference to
this so you can see that's just
literally just suck straight off the
ear canal wall now if we get a grip on this
central section now we're just sort of
sucking it into the end of the zone the
tube there there we go you can just see
it starting to move forwards now just
slow this down so you can see this
moving out we're getting a good grip
just shifting position a little bit that
section it was stuck on the ear canal wall
so we just need to bring that forwards
and out comes that plug you can see it's
all soft around the outside edge there
let's take a look in there there we are
you can see the ear drum there you
actually see the blood vessels coming
down the hammer bone there as well so
just under a centimetre 3/8 of an inch
there that's so much easier with this
ruler
I have 3/8 of an inch they're just
zoomed in a little bit so you can get a
good look at it so in that the last
patient in the compilation though guys
and this was really interested in see
we've got this dry skin bundle which is
sitting just in front of the ear drum
they're so attached to the roof ok so
attached to the sort of ceiling if you
like of the ear canal and what we're
going to do now is we're going to use
the standard size on the tube now this
patient has been getting some discomfort
in their ears not so much of a hearing
issue but more of a discomfort now
you'll see why in a second so I'm just
going to get a grip on this with the
standard size on the tube look at this
space here keep your eye on that space
ok what's what happens when we pull the
front end of this ear wax look at you can
see through the space there was a whole
chunk of ear wax sitting right up behind it
pressing against the top of the ear drum
which you couldn't see from the front so
as we pulled that down you can see it
really kind of pulled down now I'm going
to point out another area for you now
which will explain why it's there so if
you look at this section here you'll see
as we pull this down the ear canal you'll
see with the dry skins come off the
ear canal wall and still attached to this
piece so as we flex this you'll see it a
little bit more cleanly now when this
bends over to the to the left hands
there you go see how that stretches so
that skins actually detached on the
ear canal wall at that point so this is
where the skin is originated from so I'm
just so excited about this guy's
so as we're pulling this down now you'll
see we're just managing to touch it just
rocking very gently back and forth we
don't have caused any bleeding or
anything we just want to detach that the
right hand side is now detached let's
get this left-hand side attached we can
start to see this some adhesion at the
top of the ear canal as well
so just slow this down so you can see
this chunk coming away because this is
the biggest piece we take away there we
are that's come away there now let's
have another look back in there now you
can see where it was attached at the top
so that the sealing the roof of the ear
ear canal they we've got this kind of
dangling bit of dry skin hanging down so
we're gonna use the suction tube to get
a grip on that and just try and attach
that away you can see very thin so
difficult to get a good grip with a
suction tube here so we're gonna change
tools I'll let you guess what's coming
next it's not really budging you can see
it's really firmly attached so here
comes the crocodile forceps well done
for all those I guess right now have a
look at that section I've just pointed
out they're keeping the eye on that when
we pulled down with this bit of dry skin
keep an eye on it because that last bit
of dry skin extends over the top of the
eardrum look at this as you pull it keep
an eye on it let's see how it peels
there look at that peeling down so you
can see where we talked about the other
skin migrates from a central dot in the
eardrum out to the outer ear canal walls and
then migrates along the ear canal wall you
can see where this is actually detached
that's the formation there and then it's
stuck to another part of the ear canal wall
on the right side which is the first bit
I showed you so look at this coming away
look at that pulling there you go it's
coming away it's good there so we've
detached it now from the top of the
eardrum so you can see why this would
have been causing discomfort for the
patient you had all of this dry skin
attached to various points around the
ear canal still attached to the
top of the eardrum all hiding there you
know this lady had been to the GP they
had taken a look in there and really
seen any problems apart from that bit of
dry skin but all this was hiding behind
it so you can see why it would have been
causing you know discomfort for this
patient as well so we're just gonna do
it the last bit of tidying up just got a
couple these little bits of dry skin
away just get our top section it's all
about the bottom I want to tidy up so
I'll just get rid of that as well there
we go
oh if you didn't enjoy the videos guys
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comments dropping below we do read them
all may not get to replace them although
I do read them all you can see the edge
on there's a little bit dull
this is that block of skin that we
removed so you can see it's quite dry
long strips of skin in there as well so
just crash zoomed into it well hope you
enjoyed the video guys and I shall see
you again on Friday