hi everybody this is Rhys Barber from
audiology associates
uh thank you very much for watching
mobile video today i hope you're all
doing well looking after yourselves and
one another out there
uh we've just finished our morning
session here in clinic so
uh there was one particular patient that
stood out which we're going to show you
the video for today
um lovely lovely gents came through
been having problems with one side for
years and years and years
uh decided he was going to bite the
bullet come along see if we could
see if we could help him out a little
bit and this is his video it's a lovely
one to watch
so let's get this up and running
let's get my glasses on so i can see
okay so what you'll notice first of all
is that we have some very very hard ear wax
uh
it's concave this is pushed in in the
center which means that there's been
some q-tip use
um we've got some very soft uh liquid
ear wax around the outside edge because the
patience has been using some drops
before they came into clinic today
but you can see we've got this very uh
depressed
center and this very thin layer around
the outside edge this is classic q-tip
use
um it's quite soft around the outside
edge due to the fact that that
that those drops have been going in
there we're trying to peel away
now from the ear canal walls you've got this
very thin outer layer there
bringing that in trying to try to move
it across and bring it into the center
so we can detach it
you've if you've followed the channel
for a little while you know when you get
these kind of q-tip
um or cotton bud use patients then
you have to remove that outer thin layer
before you can remove that central
section in there
uh patient was an absolute trooper
you've got you're working so close to
the ear canal walls it can sometimes be a
little bit uncomfortable for the patient
but this chat was was an absolute start
an absolute star
so you can see we're just working our
way down the ear canal just slowly trying to
peel off this right hand side
but it's getting very very thin we're
working really close to the ear canal wall
so
i've switched sides now where we have
already started this left side off
pulling it into the center of the ear canal
so we're just going to pull that in now
you can see as it lifts
you can actually see it sort of peeling
off the ear canal wall you can you can see
the shape of it
as it peels where you can see the
adhesion of it as it's coming when you
can't see that as it's coming away from
the ear canal wall like that
so i've just popped into the center just
trying to see if okay well if if moving
this amount off the outside edge we can
get a little bit of movement to that
central
large section of ear wax but you can see
it's still quite
firmly held in there so i'm working
very slowly around the outside edge uh
loosening and then retrying the center
see if we get some movement
you've got a very different texture of
ear wax in the center you've got this very
hard you can see those little hairs
there because the gentleman did have
quite a lot of hair on the outer part of
the ear canal
those little hairs down inside have
dried into place you've got this
this kind of softer layer of ear wax on the
outside of the ear canal
and then this harder more dense ear wax then
in the center from ears of being
compacted and compacted and compacted
with q-tips
um but yeah it's all starting to loosen
a little bit in that central section
when i get those hairs of the way
hairs are always a bit more problematic
when you're looking at suctioning
because they can
uh stop imagine a suction grip has to
get a good good sort of central grip
there
uh if you've got a hair running across
outside that you're going to create a
gap which is going to lose some of that
suction power there
so back in though this is the still the
standard salt as on the tube i did try
to administer a little bit of olive oil
in here but you can see just didn't get
very deep it's it got to the outside
edge which is going to help us a little
bit with peeling this off
there we are you can see that right hand
side now as we're lifting
we're just trying to keep uh this all
tube just above the skin in the ear canal
just ever so slightly above
and and trying to lift then off into the
center of the ear canal
i say quite a bit in these videos
sometimes if you're trying to move
something about halfway down the ear canal
always bring the camera back and always
always look a little bit further back
because the start of it may be further
back and that's the case here as well
you can see that peel a lot more
effectively there now it's
looking as that's coming away look at
the skin underneath
it's it's pink it's this has been here a
long long time a long long time
uh what the excuse me sorry what the
gentleman expressed me when he came in
he said that um he normally has a lot of
difficulty hearing people
especially so at the moment with
everyone wearing masks and and
uh you know you you lose that that
ability to lip breathe which is really
problematic when you're hard of hearing
or if you have ear wax problems like this
uh it's a really difficult situation to
be in a
necessary situation i understand that
but it's really really difficult for
these patients
so we've got this uh really good peel
coming along now it's really starting to
work down the ear canal
i can tell now that central section is
still not budging which means that we've
got a really hardened compacted center
to this
it's going to be right down on top of
the eardrum as well it's not in a great
place
the entrance to this ear canal is actually
quite narrow which doesn't give us a lot
of movement
a lot of flexibility in there um so it
is it's uh it
it's trying to get the the kind of the
the angles you need to be able to pull
this away
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look at that one
so we've administered a little bit of
olive oil in here now you can see
the reason i put the olive oil in this
is wedged right down against the eardrum
so we're gonna have to get a little bit
of movement here the olive oil is gonna
help
us to unpeel and stop this uh blockage
from sticking again
it's also gonna help it to slide across
the skin a lot better
so i'm trying to kind of probe it for a
weak spot
but because it's so uh perfectly formed
to the ear canal walls
you can't get the wiggle you can't get
the movement back and forth you normally
need
so what i tend to do when i've got a
piece of ear wax like that is what i'm doing
here i tend to try and work down the
center of the ear wax
um trying to create a groove if you like
in the center
which then allows me to pull the sides
into that central section
so i i create the space i need to be
able to pull the sides in which is what
we're doing now
just try to lift from the bottom don't
forget we've got that valley in there as
well just in front of the eardrum
so ideally we need to try and look
because if it has been compressed and
compressed and compressed down into that
gap
the ear wax is going to naturally seep into
that valley and harden there it's going
to form this really awkward shape to get
out
just slowly slowly working this out now
you can just see the gray
to the right if i uh oh sorry they're on
set if i pause this
see the gray to the top right corner of
the
of the ear wax there that's the eardrum okay
so we're just starting to see our first
glimpse of the eardrum now and you can
see this is right down on top of it here
i'm holding the suction onto the bottom
section to really get a good grip and
slowly work this
up to lift it out to that valley
there we go it's start you can start to
see just that every time we go in just a
fraction more the eardrum
hits a little bit of olive oil on the
way in there with the endoscope so it's
just blurred to the right hand side of
the screen a little bit
yeah you can see it really blurred there
so we've just taken that out cleaned it
off going back in now
so we can see now we've exposed the
right side of the eardrum the left side
bottom and top are still completely
covered but now look when you get a hold
see that
that little bit of movement there as
soon as you get hold of the bottom
section
you see the whole thing is just starting
to move so we need to detach this left
hand ear canal wall
sorry the ear wax stuck to the left anchor i
watch leave the left hand cut out where
it's supposed to be
and then we'll get a grip at the bottom
here again
there you go just a little bit of a
wiggle coming in now just starting to
rock it just
ever so slightly back and forth not a
major amount of wiggling going on
because we're deep in the ear canal it's
gonna be really sensitive for the
patient
collapse in now pull down from the top
left hand corner
can you see what we're trying to do by
unsticking that that left ear canal wall
because we know we've got a little bit
of movement there we know that right and
bottom
is free but we know that left hand side
is still quite firmly attached
and also the top as well so we're just
going to bend this down see how much
movement we get
there we are you can see that's quite
free there's a lot of movement there as
well so
really the only thing holding this in
there is that left hand side
let's try and peel it across to the
right
there you go you can see it just would
just ever so slight pressure we just get
a bit of movement
now look it's just starting to pull
forwards
let's see if we can attach it again
obviously when you're working like this
a lot in a very narrow space you you
kind of have to take breaks as well to
be able for your arms to kind of get the
blood flow back in there but
we're going to hold on that bottom
section now build the suction
let it hold there really hold on to it a
little bit of movement look we're just
starting our forward momentum there we
go now it's out to that gap so we've got
it away from the eardrum now
we've got it to the outer part of the
ear canal i'm just trying to lift it
turn it to get it out now i know we've
got a really narrow entrance to the
economy which is also really hairy
unfortunately
um so you're gonna lose some of the
visual a little bit now as we take this
away
it's really got wedged into that space
there
turned it again to try and maneuver it
out
you can see it's just not really budging
there so we're going to use the jobson
horn now just to get over the top of it
and just to flick it forwards
there we go let's move forwards now
let's get behind it again move the next
section forwards
it's broken a little bit off there
it's difficult to see because the haze
are kind of obstructing the view
slightly
but we're just bringing this out we do
show you this on the uh
on the end of the suction tube in a
second
fighting through a little forest there
we are you can see that's one of the
pieces that was wedged down in there
there's another piece as well that broke
off just to the entrance to the ear canal
we grab that with a suction there we go
you can see that section as well
let's take a look there we are we can
see the eardrum there now
uh yes it's a little bit mottled it
doesn't look really shiny and pleasant
like it normally should uh so we've got
an
uh one one and three eighths of an inch
and a little uh just under three and a
half centimeters of ear wax there
so you can see even in that small small
gap there was so much wedge down in
there
uh all these little pieces here really
close to the eardrum
sorry let's flip back to uh let's flip
back to my view there we go okay let's
take these back off
so um yeah a really interesting one
because it
when you use q-tips and things like that
people are doing it at the moment
through
sheer desperation to try and get this
done but you can see it the effect that
has on the ear wax it really kind of
depresses the scent that compacts it
together you've got all this
around the outside edge that gentleman
filled up uh when we cleared his ear he
was
he'd gone so many years without being
able to hear
and it got so frustrated and
even now at this time when he was really
struggling to be able to pick up what
people were saying especially in the
face mass as well
and suddenly to be able to hear again
it's really it's just
it's why we do the job okay we have the
best job in the world this is such an
amazing profession to get into
and he could hear so so much better
and it makes such a big impact on
people's lives being able to hear better
my advice to anyone who's suffering with
hearing issues is
please go along have a chat i know it
seems scary to get to see someone like
us
we're not scary i promise we'll we will
just try and help you as best as we
possibly can
any trouble watcher please come along
and have a chat to us please come along
and see your local audiologist
we can make such a big difference and
it's such a simple thing within 20
minutes
we got that person hearing better than
they had done in years
in years okay enough about audiology
it was it's just such an amazing uh
experience they're really it's
it's why we do the job it's such an
amazing uh amazing time this morning
anyway uh okay uh i'm back on uh
monday uh so please tune in then for us
we're back at 9pm on monday
and uh as always guys have a great
weekend
take care look after yourselves uh and
if you are suffering with a hearing
problem or any hearing issues
come and see your local audiologist
we're not as scary as you think we are
all the best guys take care