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 for watching our ear wax
compilation video today we have three
patients in this video
so this first patients come through with
reduced hearing on just on one side we
can see some very very hardened up ear wax
here at the entrance to the ear canal and
what we're doing at the moment is just
loosening this ear wax away what you'll see
at the the base of the ear canal just below
the microsuction - you will point out for in
a second is actually a piece of dried
blood so what they've actually broken
the blood vessel here at the front end
of the the ear canal which is going to
become a little bit more important a bit
later on so what we're going to do here
is loosen from the sides now as we
loosen this drier harder ear wax what you
can see is that we've got a much wetter
substance just below the ear wax or
underneath it so you can see to the
left-hand side of that ear wax there and
these long stringy bits of wet skin
coming away so this out just drier
section here has been trapping what I
think is it what looks like a tight 2/6
earner behind it so we're going to need
to take this away to get a good look at
it you can see there that white fluffy
dead skin with a total 16 you get this
milky kind of discharge coming away from
the ear canal walls as well just to the
irritation just taking away some of this
dry abyss now the reason that blood
vessels became a little bit more
important there's a piece this is
actually dry skin at the base of the
ear canal underneath this section here which
is firmly attached to that skin right on
top of that that kind of burst blood
vessel so if I go pulling that away it's
gonna cause bleeding so I'm leaving that
they for the time being and I'll get a
good look at a bit later on you can see
this wet
skin material coming away here I take
the six June is a kind of bacterial
infection basically of the outer part of
the ear canal so irritation to the ear canal
you do telling a lot of discharge with
it and what you can see here is all this
dead skin coming away you can see it
just does it looks really aggravated in
here one of the complications you can
get with a total of 16 it is you can get
it starting to actually degrade the skin
and it can actually start to start
forming some kind of more granular
tissue and what we're doing here is just
taking some this wetter debris away you
can see a couple of little red marks and
they were talking point up for you in a
second
just how long ago they got this little
bit of dry skin just to see how firmly
attached this is but it is solidly on
top of that blood good burst blood
vessel so I'm going to leave that well
alone you can see the wetter material
here so I'm just going to start just
taking some of those bits away so I can
get a good look at the skin underneath
if it is the type of a otitis externa
that degrades the skin it can actually
get into the bone as well so it's quite
nasty now you can see some red marks
there where the skins come away and it's
exposing the kind of blood blood vessels
underneath I think this is possibly a
kind of a necrotising a type two six two
net so we sent this patient along to
their GP to get a referral into the ear
nose and throat Department this needs to
be treated with antibiotics and as a
matter of kind of a urgency really this
is our second patient here you can see
we've got some skin tissue here just
covering the entrance to the ear canal you
can see the sort of flaps of skin
they're covering over some ear wax behind it
so we're just going to use the micro
section here to get this get this out
just come into contact with the skin
you'll see the whole lot there we are so
you're peeling away is one continuous
piece there we go so a nice big chunk of
skin covering the entrance that guy you
can see where it was attached to the
right side there but trapping quite a
large section of ear wax behind it we're
just going to remove the ear wax now and
we've got some dry skin here to the
right side so we'll just take that away
here we got lovely
and there's the eardrum looking nice and
healthy so quite a simple extraction
that one you can see the same kind of
problem here on this side basically this
patient had come in with just reduced
hearing a feeling of fullness they have
had ear wax removed in the past so they knew
the sensation we've just got a large
chunk of ear wax on this side a little bit
of skin around the outside edge we can
see just breaking away there so we're
trying to get hold of that central
section here we are you can see that
coming away quite nicely a large chunk
is quite a bit more still in here so
we're just going to take weeks that flap
of skin there just start taking some of
this away getting to that large piece of
ear wax at the base there of the of the
ear canal as the front dents left a little
bit in the entrance to the ear canals we'll
grab that in there as well here we go
and we've got a couple little dots of
ear wax on the ear canal so we'll just take some
of these dots of ear wax away last little
section there can be away as well there
we go and there's the eardrum a little
bit dull so possibly a little bit of
fluid behind there so this is what we
removed from both ears you can see but
for now centimetres just under two
inches so come up to our last patient
Denis compilation now this gentleman is
quite a regular ear wax builder he's been
Caesar once or twice in the past quite
blocked at hard sections of ear wax on the
outer part of the ear canals here so
just going in with a bit of
microstructure now this quite an angular
chunk at the front end of this ear wax know
you know from previous videos that it's
easier if we've got those flatter piece
to work on this one's quite angular it's
also very dry which means that it's not
always the easiest to get a really good
microsuction grip on so what I'm doing first
of all is just trying to loosen this off
the ear canal wall sometimes we can get in
just enough of a grip and with a bit of
a wiggle it'll start moving down the
ear canal which is what's happening here but
there's a little flap of dry skin at the
top of it which is just causing a few
problems so
just gonna tray in get a grip on that
take that away if possible there we go
so now we can see a little bit more of
the top end of the ear wax we can get a
better idea of where this is gonna
wiggle its way out of the ear canal you can
see it's not quite it's moving a little
bit it's moving very slowly down the car
but not quite enough as we'd like so
we're gonna use the crocodile forceps
now just to get a grip on this and see
if we can pinch it either side so that
we can yeah so we can just get a grip
enough of a grip to pull it forwards
this simple X tends to be harder you
know so but it's soft there you go you
see it's soft in the centre which means
it's not the easiest to get the grip on
and what we're going to do if we carry
on using the foresight was we're just
going to break a whole big chunk of the
front end off so we're going to go in
with the Jobson horn now I need to bring
this forwards but also angle it to the
right-hand side because if you bring it
straight out it's gonna bump into the
outer part of the ear and you're gonna
not gonna be able to get the angle to
get it out so I'm just trying to bring
it forwards just working it down whew
see I'm always going to the same kind of
position in the ear canal so not too
deep but bringing the ear wax forwards and
then going back into the same position
and bringing it forward again and just
it just helps to slowly work it out
without digging too deeply in there
quite a big chunk there let's take a
look at the eardrum here we are there's
the eardrum or looking nice and healthy
patient has exactly the same problem the
other side but the watch is a little bit
softer on this side so it means that
although there's an angular front-end to
this ear wax when we get a grip on it with
the microsuction the microsuction will pull into
the ear wax a little bit more musically we
get that slightly better grip so you can
see it's moving a lot more when we get
the microsuction onto it so what I'm doing
here is just wiggling working it up and
down just there you go trying to work it
out the ear canal you can see that as I'm
bringing it out I'm trying to push it to
the left side there you go trying to
move it out from against the ear canal wall
on the left side but it's a bit too long
to get out so what I'm going to do is go
the jobs in horn just get above it and
push down and into it there we are
and that's ruling out there now quite
nicely get it all the way out maybe yes
it's nicely quite a large trunk there as
well and there we are is the eardrum all
looking nice and healthy so these are
the two pieces room also about a
centimetre each
you very much watching our video today
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always guys until the next time take
care