hi everybody this is Rhys Barber from
audiology associates thank you very much
watching our ear wax removal
compilation video today if you've never
come across a channel before we post
ear wax removal videos every Monday
Wednesday and Friday at 9 p.m. UK time
so if you haven't subscribed already
you'd like to do so you're more than
welcome to if you really explain a
little bit about the microsuction
machine today because a lot of people
are asking about it in the comments if
you're not ringing that interested in
the tools or my voice a little bit at
the beginning you want to go straight to
the ear wax removals there are chapter marks
in the scrub line then there just scroll
across or you'll see where the first ear wax
removal starts just go straight there
and it'll take you straight through to
the end if you do that there's one thing
I would ask you to do can you stick
around at the end of the video because I
need to show you something and ask you
what you want me to do with it which is
going to make a lot more sense when you
get to the end of the video ok so a lot
of people in the comment section we're
asking if they could have a look at the
machine that attaches to all the tools
that we use so this is our this is our
suction machine ok so if I just unplug
it from the back there so you can see so
this is this is what we use to suction
the ear wax out so what we have is a suction
pump in here we just attached to this
little rubber tube that goes over the
top going through a filter and that
creates a negative pressure in this
little tank at the front here which we
because when we collect everything
attached to the tank there's another
tube that comes off which gives a little
bit end here which we can attach the
tools to so basically it forms the
negative pressure in here which draws
over things through that tube so
everything collects in the tank here so
there's no direct connection from the
suction pump to the patient or does it
play the tank there as far as the noise
of people sleep at night I plug this in
and just turn this on if I can find it
on the friend yeah
[Applause]
it does have a variable about the
suctions this little dial here will
change the amount of suction that we can
we can have going through the machine at
any one time and basically we use it use
most of that I won't fall false or
suction because it's very difficult to
get a lot of the ear wax out and when you've
got the very low suction level there
it's very difficult to maintain grip on
the ear wax and things of that so what the
patient he is in near EU is not all that
kind of vibrating sound there they hear
more like a rushing or a roaring sound
so if you've ever had a really strong
wind blow past you yet together so
that's the kind of noise it makes in the
when all the ear wax and stuff gets sucked
in many sorts of crackling popping in
sometimes squeaking noises if there's a
bit of dry skin in there so that's the
suction pump we used if there's anything
else you guys want to see drop it into
the comment section below and that way
then I can include it in in future
videos for you so without further ado
we're going to go into the UX removal
part of the video now so if I just click
here my glasses on make things easy for
me so we've got two patients in this
compilation video the first patient that
you'll see here is a very very sticky
thick ear wax so it's stuck to all the ear canal
walls
stuck and bone together so these two
boxes tend to be more problematic than
the harder section once you get because
they stick in all the different places
they form a really really good seal on
the ear so it's really difficult to to
get the sewn through then with harder
ear waxes you can create gaps and things in
the zone will still get through but that
you can see as we put those on the tube
on here it's very thick sticky material
that's being that's being pulled in I
know I can paid it to figure holes and
Fig Newtons last time it's a very kind
of similar similar kind of consistency
in the USA so slightly granular with his
little heart of its in there but as you
can see what we're doing is we're trying
to lift from the ear canal walls at the
moment I've introduced just a little bit
of olive oil in here which is going to
help to stop the ear wax from re sticking so
it forms a barrier on that on the ear canal
wall which then stops the ear wax from rebuy
into that again because it is such a
sticky yet sticking the inner to it so
you can see we're just slowly slowly
pulling this out to the ear canal it's
really hard when you've got the softer
material like this when you're getting
the grip obviously because there's
there's not a lot of structure to the
ear wax if you like it draws into a point of
poles like there so it's it's so the
poly almost almost almost a kind of
liquid material in so you don't get that
nice grip that you get so what we'll
find normally with this type of ear wax is
the outer areas will be very soft so if
patients have used a bit of olive oil or
drops or something that really softens
the outer edge when we get a little bit
further in the ear wax does then tend to
have a little bit more of a solid nature
so it means it's a bit easier to get
that grip on there than which is what is
just starting to see on the video now
you can see that did the actual shape of
the ear wax is starting to change we've
still got this soft edge but notice how
it's now drawing so what we're doing
with this is gripping the top pulling
down gripping the top pulling down and
then we're working back up in the
opposite direction so we're drawing the
top forwards bringing the bottom drawing
that forward so it's kind of like an
exaggerated wiggle coming down the ear canal
then you can see it's really starting to
come away we're getting a little bit
more movement no way talk to you in the
videos before about seeing the whole
thing starting to move and you know then
you manage to detach quite a bit of it
so we're just starting to see that
happening now we've worked it from
deeper in the ear canal to the outer parts
that you can are now so we're right on
the outside edge we're short visible
here come out here just Kenz that when
you get to this outer section the scylla
tend to come so just pass in front of
you just see them there they are very
very fine but because obviously you have
to work slightly behind you to at all
with the endoscope sometimes the scylla
they're more boards kind of getting away
a little bit as you're pulling out but
it's just starting to move is it's so
close to coming out of the ear canal there
we are now is think you see if we're
pulling now from the left across to the
right so we're just starting to get a
little bit of movement
trying to really hold on you can see I'm
wiggling around in circle Street police
I would slow this down a little bit so
it's on its way there we go just now
they door there it comes so you can see
all starting to work out to the ear canal
now look at the color of it it's really
deep deep brown almost an ebony and
color - very very dark very very dark
now I know a lot of you gonna go nuts
about that here that's down there if I
couldn't get it out only because it
leads so flat across the eardrum when
you're suctioning to try and get these
over here so a lot of the time I use
forceps to get them out with that here
it was stuck across the top of the ear
from there okay
now if you go trained suction that
you're gonna have to suction on top of
the eardrum and hold it there to try and
get a grip I couldn't peel it away so
what I advise the patient to do is next
time they're the bath or shower just
little bit of water trickle into the
empty back out because what that will do
is it will flush that here away a lot
more safely than me going in there
trying to take that off I do try and
take about as best that guy I know it
drives you guys and nuts but in some
cases it's safer for the patient to do
that themselves and for us to try and go
in and do it so this is still the same
patient the second ear now and you can
see a very similar consistency in white
but look at the color difference unit a
little bit lighter in color there's more
lighter brown colors with it it's a
slightly younger ear wax it's not as old as
the other side still quite sticky though
and and ear wax consistency varies so much
from person to person you get some
people with really rock hard ear wax some
people was really sticky soft ear wax and
it's the people with this type of ear wax
the stickiest softer type that have to
come through a little bit more regularly
to get their ears cleaned out so still
what the standard says all the - at the
moment just trade the workers down you
can see what I mean about when we talk
about the whole thing moving we're not
getting that the bond you can see it's
just the front section of ear wax that's
just bending back and forth as well as
we get a grip on it
trying to pull this out I edited this
video a couple of days ago so I can't
even remember this next bit so it says
this is why I've been quiet every soft
things I try to work out what we do next
so there we go with justice here was
really lift from the base they were and
sticking from the base of the ear canal then
you just start seeing a movement they
were stuck again now can you see we've
just got the front section moving at the
moment we have the whole ear wax block
moving now did you see that whole thing
move forwards then that indicates that
you've got the grip with turning now
we're spinning the ear wax around to try and
get a good grip on the flatter underside
as we rest it against the ear canal because
you bet you can sometimes get a better
grip on that particular section then we
go and get a good grip now it's working
out we've got a good solid suction on
there lots of wiggling up and down to
get this out ass just stretch the outer
section off they are unfortunately
hopefully then the section will be a
little bit harder as well yes so it is
moving it's really wedged in the outer
part of the ear canal this is the
entrance to the ear canal you're seeing here
so it's kind of just wiggling and
pushing down and pulling forces to try
and get this out it's really wedged so
we're going to go in with the Jobson
horn at this point just tuck behind it
that little scoop - yes behind the ear wax
bring it forwards drawing it down then
we are we can see now we've just got a
little block left to the right side so
I'll just remove that that's the only
downside of using the jobs in horn on
this most sticky ear wax is you tend to as
you pull sometimes it'll pull through
and just resit some of the ear wax to the
ear canal wall but I don't think we would
have got that out without using the
Jobson horn though I don't think it
would have got out that I was a section
there there we go and we can see the
edge on there there's a light reflex
there so those shiny bit of the ear
drum you can see so in inch and 1/8 just
under three centimetres a some quite big
blocks few people mentioned but the
light reflex is why it's important
because it shows you where the you drum
is sitting if it's too cold it or two
bowed out the light reflex you lose so
it's a good indication of middle ear
pressure and
from health was another question and
soon people came up with we've gone to
their complete other end of the extreme
though as far as ear wax is concerned so
this is a very very hard dry ear wax more
commonly people will end up with dry
skin in their ear canals we can't get a
grip on this with the standard says
honest we're going in here now with the
Jobson horn just getting that little
scoop behind the ear wax drawing forward
you'll see the whole thing comes out
it's all the white material there on the
underside that's actually dry skin so
you can see why the ear wax had dried onto
the ear canal wall there the skin itself was
really really dry it's just dried the
ear wax had too much so the ear wax has gone
from this sort of more softer material
into that harder tougher material on the
outside then dried out completely which
is what we're seeing here same on the
other side so this is the same patient
but the second ear here you see a
little flap of dry skin just hanging
down from the top of the ear canal there
so we're going to get rid of the ear wax
first and trans you think this difficult
to remove anything like that with such
and just because it's holding on so
firmly so I'm going to concentrate on
getting the ear wax out first we can go back
to a little bit of skin after so we're
going to use the Jobson horn again
perfect ear wax for Jobson horn this one
it's just on the outside parts of the
ear canal easy to get all over the top
and draw forwards maybe that's just
starting to come away you can see it's
that much lighter color is also I could
still teeth on top as much much much
lighter in color as well as you guys we
pull this away you can see that dry skin
there as well just adhering to the outer
portion of the ear wax there there we go so
that's popped itself out now so you can
see it it's like a pebble and if you
pick these up and touch these and
squeeze them they'll feel really hard in
between your fingers so it will be quite
a tough tough tough bit of ear wax it's it
is like a little stone or a little
pebble in the you cannot you can imagine
that is quite uncomfortable for the
patient there's a little ring of ear wax
here we don't always have to get that
out it's just sitting down in the ear canal
a little bit so it will shift that in a
second you can see what I mean returner
detach this dry skin
it's really tough it holds on there
really firmly so I find the easiest way
to do it is with a Jobson horn just to
kind of working on the saber to take
over the dry skin away there we go you
can see that there those two little
pebbles and whacks I didn't do this in
inches unfortunately so I write that's
about 3/4 an inch but you can see
they're really tough tough little pieces
there okay let's switch back to the
normal view just for a second so put
these back up um yeah two very different
and extreme types of ear wax they're the
very soft sticky which does tend to
cause quite a few problems with patience
as far as the hearings concern but
doesn't tend to be too uncomfortable in
here and then this very hard dry solid
pebble like ear wax that turbot can cause a
few problems right I said at the
beginning I'm going to show you
something and I want you to help me
decide what I'm gonna do with it so this
happened today from one patience so show
our patience one ear okay so we've got
19 centimetres seven and a half inches
of debris okay very tough or came out of
one patience here now I need to decide
what we're going to do with this video
okay now what I'm thinking might be
something a little bit different to do
is we've done a few lives where we've
done cured AIDS and things of that but
with this format it makes it a little
bit easier to do a live commentary over
the video so what I'm thinking is if
it's okay with you guys in it you guys
would be up for it is if we did a live
video with that one I'll lay to
commentate over the top of it and then
cuz you're gonna have I know you're
gonna have a lot of questions about that
at the end then I can go back to this
kind of format here and you can ask me
whatever questions you want about that
video if that sounds like something
you'd like to do then drop me a comment
in the section below so I know I know
that's what you want that that's what
you'd like to do I'll try and do it to
you to you and to Facebook at the same
time if we can but let me know if
there's something you'd be interested in
okay in the comment section below
right there guys it is Wednesday today
so I shall see you guys again on Friday
that video probably the one you saw
probably go out I would say beginning
part next week maybe so
no but that one but as always guys take
care and stay safe