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 [Music] hi everybody this is Rhys barber from audiology associates thank you very much for watching our election what I do today we have two patients in this compilation video the first patient has some very very deep dry and impacted ear wax this looks to me that could be the q-tip used because there’s a nice big dent in the in the front end of it here and the outside edge is there and you can see her coming across the ear canal wall more towards the entrance to the ear canal so you get this kind of pushed in middle which tends to happen a lot with cute abuse so what we’re going to do today is we need to unstick this out edge first of all so I’m using the standard saves on the tube here just to try and free up the outer edge of the ear wax pull it away from the ear canal walls because obviously if we work straight on the centre and try and pull forwards this is gonna hold it in place so we’re just taking that away you see the first bit you can see how because this has been kind of compressed together with what I believe is gonna be the q-tip you can see it’s kind of squashed the ear wax together now ear wax can be kind of what’s the best way just going off fluffy but kind of that kind of more open texture to it whereas this now it’s got that more condensed texture somebody in the comments said they come up with a perfect description which it’s like fudge if I don’t want something fudge as an American thing as well but you can it’s that kind of consistency that you get it’s really kind of thick thickened up kind of consistency so what we’re doing though is just taking all that outer edge where you can see just exposing the ear canal wall underneath it’s really tough all stuff this oh it’s very deep so not the most comfortable place that were taken away from because obviously the deep you go into the economic most sensitive everything becomes so and we’ve got to work really close to the ear canal wall to be able to peel it away so we’re trying our best not to touch that ear canal walls we don’t to make it and you know too uncomfortable for the patient we’ve got a nice kind of projected out bit here so we’re just grabbing that section taking that away now some people will probably be asking themselves well if it’s that very why you wouldn’t use olive oil on this the really simple answer for that one is this patient has really quite dense cilla sort of fine hairs on the outer part of the ear canal now I know if I go spraying olive oil in there it’s just gonna completely coat those Cilla and it’s gonna make the view here really really difficult to see because you don’t the want olive oil stick to those and coat the end of the endoscopes you don’t get a particularly great view so I’m just do as much they can without using any olive oil you can see we’ve got this kind of more hardened up section there in the centre lots of little tiny hairs embedded in there from probably ear here trims just breaking that front section away there and just pulling that down I’ll lift the ear canal you can see lifting from the ear canal ball there at the base yeah I know estancia our first glimpse of the eardrum there now pulling it of the ego so we’ve detached it now from the left Corral wall the right ear canal you can see how much more easily know this ear wax is moving so just trying to work this out just getting a grip now we’ve got this flat edge we can get a grip you see with the crocodile forceps so just trying to use the crocodile forceps to take this out but it’s just broken away in the centre so it’s a bit too soft but too hard to sort of microsuction really effectively but a bit too soft to get the crocodile forceps to hold onto it tight enough and and keep it’s kind of shaped to be able to pull it out so I’m gonna do is bunch a lot of the ear wax in the end of the of the microsuction tube so really kind of jam it in there to get a really good strong microsuction grip which is what we’ve got now and then I can work on the flatter edge look to remove it here we go out pops and it’s got a little bit of a little bit of ear wax there at the base of the ear canal so we’ll just take that away with a microsuction there we go you can see the edge I’m looking nice and healthy and there okay now this is the second ear of the same patient you’ll be able to see from this one we’ve got some you know very very impacted ear wax really sitting on top of the eardrum we also got this kind of white section to the right-hand side of the ear canal just come into view now there we go so that’s actually a piece of dry skin that’s been kind of rubbed almost like like a like a callus kind of consistency so you get this hardened up top layer of skin so I’m just gonna outwork it’s protruding out a little bit so I just want to just do a bit of gentle probing of that so we’re just gonna microsuction along that in a second and obviously if you when you guys watch the episode 200 you know that we’re constantly talking to the patient the whole time so while I’m doing this I’m always checking in you know making sure this is not uncomfortable is this painful at all for the patient this patient was an absolute star he was so good a genuinely lovely guy so he was absolutely fine with us carrying on he was he was at the mindset of whatever it takes to get it out absolutely fine it’s not uncomfortable or carry on so he did really really well they were going just see it starting to bend away from the ear canal wall there you can see where that hardened up layer of skin on the top you’ve got this much sort of wet newer softer skin then underneath you can see it there so I’m just trying to get as much little way from that as I can before we look at taking this out really you can see it’s really welded really welded on to that ear canal wall it’s it’s it’s not gonna budge really easily here just trying to gently lift using the the edge of the microsuction tube there to remove it now you can see the view we have here now what we do sometimes is we get the patient to bend their head over to the opposing shoulder which you can see changes the view so I can see a lot more at the top of the ear canal now so the patient if you imagine is leaning their head over to that towards their shoulder which then allows me to work on that top section and you can see when I grab them much more like here getting this ear wax away so we’ve got a nice big leading edge now so the crocodile forceps are gonna come up with this one just pinching pulling forward ever so gently there you go and then unfortunately a bit broke away but what we’re doing now is using the Jobson horn to try and get behind this see if we get more luck with the Jobson horn it’s this really odd Caitlyn whoops no you push it back up this really odd consistency of ear wax this one because it’s it’s tough but a little bit brittle so if you imagine if you like we said fudge that fudge consistency that’s what you’re looking at so it’s quite solid until you start pressing into it and it starts breaking apart which is what’s happening here so I’m just gonna manoeuvre the ear wax and then sometimes we’ll alter grips are going a little bit further you go just to shoot and grab a piece behind it but that’s breaking away sorry again with that Jobson horn there we are now we’re starting to see it move we’ve pressed the side down now so we can get behind it a little bit more effectively move for the pop down oops back to the camera no way through so what you can see now there we are there’s the eardrum is that white bit of sort of dry it’s not rightly said like a where the dry skin was so this is what we have here in centimetres and in inches this is one and five-eighths one and eleven sixteenths thank you very much to Pete who sent me the inches measurements now it’s broken down so I can actually get it right this time so what we can see here this patient has a big skin flap that’s fallen down into the ear canal so are really big so long skin blockage so what we’re gonna use for this one is the standard size on the tube just to get a grip on the outer section here this is just gonna loosen it from the ear canal wall not always the easiest thing to take away with microsuction skin debris just because it’s it’s noisy so you get that really though squeaking sound coming through switch we try and kind of manoeuvre it and put it into a better position so that we can use a different tool than to get out in this case we got a nice pocket of skin so we’re going to use the crocodile forceps just to get a grip on that here we go so you can see just putting a bit of tension on it try not to pull it too hard we don’t like the tear but unfortunately there it goes so it tore the outer section so we’re going to go aim a little bit further in get a nice good grip on this piece Jen terminal there we go and out he pops you can see just how wide that skin flap was so that was completely enclosing the ear ear canal so there’s the ear drum they’re looking nice and healthy I sit in centimetres I see easy that’s an inch there you go that’s easy one you very much for watching our video today if you did enjoy the video then please like if you not subscribe to idea you’d like to do so you can click the subscribe button here if you’d like to check out some more videos there also up there now if you want to follow us you can do on Facebook Twitter Instagram and also check our website if you want to know a little bit more about us as always guys until the next time take care

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