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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


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