hi everybody this is Rhys barber from
audiology associates thank you very much
watching that you ear wax removal
compilation video today we've got two
patients in this compilation video we
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so this first patient has some very very
dry ear wax now if you joined us for the
live on Monday then you'll know that we
were talking about there are different
types of ear wax and people from different
backgrounds have different types of ear wax
so this person was from an Asian
heritage and what you get then is a very
dry type of ear wax that forms these sort of
plates of ear wax so we've got the standard
size on a tube in here you can see we're
just slowing this down so you can see as
this comes out the layer of kind of dry
skin that's built up underneath so what
we end up with a lot of the time here is
lots of layers of ear wax that form one over
the top of the other and you'll see that
a little bit later on as we start to
pull this out so it's a bit like
unpicking and not this you have to take
one piece away which allows you to get
to the next section see that plate there
look as it came away so we're just
taking these thin plates of ear wax away
just so we can kind of loosen this whole
chunk up to get the whole thing out
didn't see we're just slowing things
down just so you can get a good look at
this coming out here there we are to see
what I mean about these plates look very
very thin but layered very closely over
the top of one another thank you to
everyone who tuned in for the live it
was lovely to speak to you all and tried
to answer as many questions as you
possibly did if you haven't seen that
one already go back it was on Monday and
check that when I was a really good
watch I'm really starting to break this
down oh it's all starting to come away
really nicely there we go
and if we take a look behind that then
you'll see behind that the eardrum and
ear canal look lovely really really shiny
couple of little tiny you'll see a
little tiny circular outlines on the
eardrum then if you just nip back a
little bit you'll see it those are
little air bubbles that sit behind the
eardrum so sometimes if you get a little
bit of fluid that builds up behind the
eardrum I'd know few people are asking
this question the other evening you can
get these a layer bubbles that form
there as well it's quite common so say
patient over there second ears you see
we've got this same thing again lots of
very very thin plates again the standard
says solitude was doing really well here
to pull these out you will find there's
a little bit of dry skin around these as
well sometimes which can if you're
unlucky it can kind of hold that plate
in this you don't really it's much more
difficult to pull out and you'll see
sometimes when we pull these little
plates out there'll be a little bit of
skin attached to the back of it we are
starting to come away now the patient
had been using some olive oil in here
just to soften this up and that does
make a difference when you look at this
very kind of dry type ear wax like this it
does help to soften it around the edges
loosen those plates apart from one
another a little bit you can see that
skin there was holding that piece of
metal wiggle quite firmly back and forth
you've got those little bits of dry skin
they're just getting sucked into the end
of this all in a tube there and he
working this up and down just to peel
these little pieces away and you've got
another piece just sitting a little bit
further in just got a little blob of
olive oil on the top of the camera there
but we can see this bottom section so
we'll just aim to get that out first
give the camera a quick clean and you
can see that last little piece left in
there now so we're gonna try and get a
good grip on this with that with the
standard size on the tube here you can
see it's actually flicked some that dry
skin up as well which does make it a
little bit more problematic sometimes to
get these pieces out look how that pulls
away do you see a drew from the side of
that chunk they took that dry piece of
skin away as well I can see how it's
embedded into these pieces of ear wax just
trying to lift from the side and there
you go using the using that layer of dry
skin against the ear wax really so we're
trying to slide that from underneath
this block of ear wax and then we can
actually take this section away you can
see how this now I'll start to move I
got a good grip there
maybe ours in another piece of skin look
how the whole thing no see how it
unravels when you take that one sort of
linchpin piece away then the rest then
will almost collapse down on itself and
start to draw out quite effectively yeah
yeah we've got a good grip on this last
piece a little bit of dry skin left in
there it's one tiny little piece comes
away really quickly here we go if we
take a look behind that now there you go
you can see the eardrum itself looks
really shiny really healthy you can
actually see the outline of the the
ossicles there as well through the skin
so this is what removed lots of little
long pieces seven and a half centimetres
probably bunched that together we get
down to about seven centimeters so just
under three inches there as well
so quite a few little bits and bobs in
there so this is the second patient no
compilation I was asked the other reason
on the live whether we can tell if
somebody's used cotton buds you can see
this ear wax it kind of makes your heart
sink a little bit when you see this type
of ear wax because it's gonna be really
difficult to remove what you have is
very very dry ear wax that's been impacted
down to the eardrum and pushed into that
Valley as well which means it's gonna
have dried into this much wider shapes
are very very difficult to remove so the
first thing I've done here is pop a
little bit of olive oil in which is just
gonna help to to loosen the ear wax it's
going to help to soften the front end of
it because we're gonna need to get a
good grip here and actually lift this
ear wax out of the valley we have to work
very carefully though because if we lift
too high then the back of the ear wax will
actually push against the eardrum which
is really uncomfortable for the patient
and we can't really wiggle right to left
unfortunately because the back end is
still resting against the eardrum and we
just don't have the room in there so
it's always a really really difficult
one to remove you can see at the mall
we've got the fine end on here so we're
just literally just touching onto the
ear wax you get a better view of it now just
touching onto the ear wax it's just lifting
little sections of the ear wax up you can
see them we're actually getting the
olive oil underneath which is going to
help it to detach from that ear canal wall
just very slum trying to gain any little
bit of purchase on this ear wax to try and
get it out the most difficult part is
going little right-hand side of this
because it's sitting just behind that
the lump of ear canal wall there so it's
gonna be difficult to bring it around
that section you can see I'm holding on
to it using the power of the suction to
bring the ear wax towards me rather than
pushing against it and it's just lifting
just slightly out of that little Valley
try to hold there to get a good enough
grip to hold onto it but because
obviously the ear wax is so hardened up in
there it's really bound to those ear canal
walls so just trying to lift again
trying to work the the olive oil
underneath that block holding and
they're waiting for the suction to bill
trying to maneuver this out you can see
really struggling this is that the wider
end as on the tube here just because you
get a little bit more suction with it
Finance great for maneuverability but if
you want to get good suction grip you
have to use this wide around you can see
we're just start to pull the right side
of this ear wax across just ever so slightly
but it's settled back into place again
so it's really difficult later to get
the grip I need you can see you've got a
little bit of dry skin that's what's
getting suctioned into the into the fine
end a we're gonna aim for this left side
now we know we've loosened the right a
little bit let's see if we can loosen
this left we can draw this forwards it
means I've got a better chance of
pulling that right side of ear wax across
into the space to get it out you can see
just trying to lift not really getting
very far with that gonna aim as close to
that right ear canal wall as I can without
touching it it's a really delicate
procedure trying to hold on to this you
can see that little flick at the front
there a little bit of movement there
there now we're starting then we'll see
it pulling across so we have to get it
out of that Valley no just in front the
eardrum without touching the eardrum was
going to try not to touch the ear canal
walls as best we can
if you've ever played the game operation
it
very much like that so we're using the
the the wider end though just to get a
good grip there we go we've got that
good suction look at the difference in
the suction grip you see we've got that
good grip they're holding onto that
letting the suction build you can see
the dry skin peeling there from the
right side the bottom left hand side as
this is coming away there we go got it
so out it comes so we've managed to
maneuver it from that section there
you'll see now when we go back in
there's a little bit of dry skin there
to the right hand side but you can see
that lump of ear canal water and how much of
it was was sticking behind that that
raised section there's a trap between
that little raised bump to the right and
the ear drum itself ear drum looks
really good
it's nice and shiny you can see a
discoloration patch to the left hand
side just where the ear wax has been but
that's looking really really healthy
they're really nice looking ear drum
nice good nice light reflex so we've got
or just over three eighths of an inch
there but a centimeter you can see that
that piece was actually quite small but
very problematic