hi everybody this is Rhys Barber from audiology associates thank you very much
for watching our video today a slightly different video for you today most
videos are large amounts of ear wax but this is a much smaller amount of ear wax but just
a very very difficult position for the ear wax to be in you can see the ear wax is very
thin layers but it's coated the ear canal wall in the eardrum and it's hardened
up so it's just causing this patient or reduction in hearing it's really very
delicate taking it away so we're going for the smaller fine end on the zoellner
tube so we can do a bit more delicate work it's a tricky one to do this
because you have to work very close to the ear canal wall so as you can see we're
peeling this drier more solid ear wax away but because you're working so close up
to the ear canal wall you do run the risk of catching the ear canal wall and then you
can get a little bit of bleeding it's very uncomfortable for the patient so
what you'll see us doing is we get very close to the ear canal wall without touching
and just scraping on the top of the ear wax just to try and lift it slightly so that
we can get there you go you can see it lifting off there so we can get a grip
there as it lifts off the ear canal we can work a little bit more safely than one
that comes away you'll see all the white bits attached underneath that's where
the skin which naturally migrates out of the ear canal hasn't been able to do
that very well because of this solidified ear wax on top so next thing we
used to know is it's just clear a little bit more the ear canal and then clear that
clear that eardrum so you're just peeling away here this is a difficult
position to peel this bit where it just hits that that little Ridge there just
before it drops down to the other side it's always really hard to peel it to to
clear really ear wax that's really adhere to that section it's quite painful for the
patient because you're right on this Ridge we'll just switch to the edge on
now you can see it's just very very gently pulling on that ear wax not too
aggressive with this because obviously this is a very delicate part of the ear
the membrane is paper-thin we have to be so careful here just for very very
gently lifting this dry ear wax away but because it's formed this solid layer
it's really reduced that that movement of the eardrum so you can just see the
white skin sucked in to the end of the searchers just very gently now the
patient this point is completely awake they're fully aware what's going on we
explain this we're going along exactly what we're doing for the patient but we
always give them proviso that if there's any discomfort any any problems
at all they can stop this procedure at any point this patient was perfectly
happy no pain felt just let us carry on it and get all this away for them so
pealing we're trying to keep it in one long strip if we can what you'll see
underneath now as we take this away you'll see the skin is quite white
that's because this ear wax have been interrupting the the radial migration of
skin if you want to know what a movement of skin we did a video on keratosis
obturans which shows the migration patterns of the skin in the ear canal
have a look at that it will explain this in a bit more detail but what we're
doing now is just trying to take this away you can see there's a little bit of
movement to the eardrum there so I'm putting a little bit of olive oil in now
just to help to loosen this off the ear canal
we're just taking some of the excess away it'll just help the olive oil to
get underneath reduce the adhesion of this ear wax to the to the skin underneath
it we are working in a very small area here you're talking about width of that
eardrums probably about a centimeter across so you can imagine that we're not
we're making very very fine movements I'm trying to pull this the flap of ear wax
from right to left to try and detach it I'm actually running out of space
when I suppose I got far enough across to the right side we have to lift from
the bottom up which is what we've done there
so that's come away now there's another little piece you can see just at the
bottom of the eardrum this will take that away as well because the olive oil
has done it's magic now that's coming away nicely there we go that's looking nice
and healthy now this section I'm working on here this is this can be quite
uncomfortable for a patient I've removed this Ridge working along that kind of
ridge line you can see just in front of the eardrum there is always quite
difficult and other patients can't tolerate it so I've spotted that there's
a wider section here there we go so we must peal just away
and you can see with the smallest suction tube its difficult to get a good
grip on it so we're gonna have to go to the larger suction tube now just to get
a better grip so lifting all of that away you can see the olive oil getting
underneath helping us to work this off the ear canal wall yeah and then we're gonna
try and collapse it down on itself from the top as well way you can see it
coming away there quite nicely here we go nice large piece I think there's
another little bit maybe I'll just in just in the ear canals we'll get rid of that
next I'll just get away some of this sluffy material in a second there will be
some ear wax left in here are lots of people ask you know why didn't you clear at all
why didn't you take it all away in some cases it's just too uncomfortable for
the patient to have it taken away from that spot and as long as it's not a huge
amount of ear wax the natural migration processes can kick back in now we've
taken the majority this away so yeah I see some redness to the eardrum there so
this is what we removed only small pieces but obviously causing this
patient a lot of discomfort well thanks again for watching today guys and if you
did like the video then please like share and comment thank you very much