hi everybody my name is Rhys Barber I'm
the audiologist here at audiology
associates we upload new earwax removal
videos every Monday Wednesday and Friday
at 9 p.m. UK time so please consider
subscribing hi everybody this is Rhys
Barber from audiology associates thank
you very much for watching our new axe
removal video today
this gentleman's come through he's quite
a regular patient of ours he's asking
through about three months ago he
suffers a lot with dry skin issues in
the ear canal a kind of borderline
keratosis objects and we have started
cleaned up quite regularly so he's
coming for both ears to be cleaned out
today you can see that this skin has
really dried up you talking this is only
12 weeks since his last microsuction so you
can see how quickly this buildup which
happens quite a lot with skin so we're
using the Jobson horn here just to
manoeuvre some of this dry skin towards
the outer part of the ear canal and
break it down with dry skin issues like
this it tends to be that it's too
tough a lot of the time to remove by
microsuction certainly the older bits around
the edge can be quite difficult to
remove so that's the reason we're using
the Jobson horn on here at the moment
you can see we're just working this
block of skin down the ear canal we did do a
video on keratosis operon so I'll pop a
link up to the top right corner for you
so you can take a look at that and
that just explains that the reasoning
behind it but what we have here is layer
upon layer of skin that's four
overlapped and formed one over the top
of the other so you get these kind of
striations of skin in here though
sometimes it'll form in a solid block
which means that you can take it out in
one big chunk we've got a video showing
that earlier on this year but this was
actually formed in layers and you can
see as we're lifting this up now we get
a grip on this outer section discovery
to that piece first you can see how dry
some of these pieces are
just working our way around the edge
what you'll see in a second I'm going to
show you the striations oh I can show
you the overlapping skin there watch now
as we microsuction tip peel apart so you got
layer upon layer of skin like this
overlapping one that this drying up so
it's really toughening and because
it's layer upon layer it's almost like
an overlap so you really binds together
quite well so I'm just using the
crocodile forceps now just on this
section just remove those two layers of
skin there which will help us to get
behind it except the one that they're
flicking up in front of the microsuction
let's try and work on this next section
now you can see it's slowly working the
way down and we've had a few people ask
us recently or comment on some really
old videos from the first few we did we
didn't add voiceovers onto them whether
we would go back and voice them over
I've looked into it I can't find any way
of adding a voice over to an existing
video so if you'd like us to do that
what I'll have to do is take those
videos down and then re-upload them but
with a voice over on that probably would
mean you wouldn't get any new videos for
about a week because there's quite a few
out there - voiceover so I'm gonna put a
poll up if you guys want us to do that
then click in the poll in the top right
hand corner of the screen and that way
then it lets me know whether you want me
to do that for you or not if you do
click yes and if you don't know okay so
we just take in some more of these
pieces awaiting see you slowly
working our way down this ear canal lots
and lots of very dry skin pieces coming
away you can see just how much it
accumulate and don't forget this is this
is only 12 weeks so it's not a great
deal of time for all this to be building
up but as you can imagine skin is
produced all the time in the ear canal I
think what we've hit here is a little
bit of earwax that's caught in the middle
of all that skin as well so we're just
going to need to get through this layer
to train remove the remainder so you can
see it peeling away so the skins
actually held in by lots of pieces of
drive actually rather there's what that
dry skin I'm sorry there you go so you
can see that piece coming away there
it's left a bit of a gap at the top now
which allows us to move some of this earwax
over to the other side you can see just
how tough this is it's breaking away
with breaking away in tiny little
pieces
the reason I'm using the microsuction at the
moment it's because we were about
halfway down the ear canal okay so to use
the Jobson he need to use two jobs
not to break this apart a little bit
something like a st. barts hook with
this type of problem were just literally
sticking it and plow through the middle
of it you wouldn't gain anything by
using the hot because of a few people a
skier white where we don't use that too
often it's this such a specific type of
earwax or specific scenario where I would
use the hook where it's most helpful the
majority of the time you're using things
that jobs and horn instruction tends to
be a little bit more helpful for the
majority of cases that we see so you can
see we're pulling through the front end
of this dry skin there we go you can see
it's starting to peel down the ear canal a
little bit breaking the way at the edges
there we go start to come forward just
pulling this down the ear canal away from
the rear of the way from the rear of the
ear canal there we all see the ear drum is
you can see these layer upon layer of
skin there so we'll just train microsuction
this piece see if we can get a grip on
it so we've got a good grip you can see
just how tough that's held in
there so I'm going up to use the
crocodile forceps now because it looks
like it's holding together let's take
the front section away
just gonna trying to get a better grip
on the rear of this section now it's
moved it outs like this you can get a
grip behind that dryer P there we go now
you can see you can see it's much easier
to use the forceps to grip this and pull
it out then to try and get behind it to
drag it you can start to see the ear
drum there now so lots more these dry
pieces you can see that the pinkness to
the skin in the ear canal there as well
it's your dried out that skin is just
taking layer upon layer away a minute
here we go you can see that you can see
the flaps the skin there whip that's
getting sucked into the machine now so
you can see the layers like as they're
forming so this is where they're forming
from they're much deeper in the
ear canal
lots of white skin layers there we go
just trying to get a grip on this piece
of earwax at the base but that bit of dry
skin there all that skin layer is
holding it in place I can't quite get
the grip I need you can see it flicking
around behind that white piece of skin
just trying to get a good grip on it but
it's quite an angular piece so not
really able to get a really good grip of
the microsuction it's gonna try and move some
of this skin out of its way if possible
but it's actually attached at the rear
as well so crocodile forceps gonna be
the best option we've got very gently
yes we are sitting just in front of the
ear drum so you can see just gauging the
size just gonna grip on the edge there
he comes so I hope that one pops what
we'll see then is Xavier drum there you
can see a layer of skin here to the
left-hand side more skin behind it which
is looks like it's still attached to the
ear canal wall a little bit you can see that
was just so attached to the drum
there we've got a piece at the top left
here just pulling that down
I know you can see it working it down
from the cat the attic region to the top
of the ear canal wall you see the layers
there look it's coming away in long
strips now what I'm gonna do in a second
we've never really done it before we're
gonna zoom in on a particular portion
away then you last about a second or two
but as we pull this watch the zoomed in
section you'll see it pull off the drum
they do see out pulling down towards the
camera so that actually came away from
the drum so that's where all this starts
so you can see it all beings are
migrating from the drum down the ear canal
wrapping over itself drying out the skin
would normally start as this is here
which is this very soft no wetter as
such but this softer material
softer skin and as it comes away from
the ear canal and it dries out just with
body heat and because it's detach from
the ear canal wall into there harder tougher
layers of skin you saw there we go a
little bit more
was the same clip again then sorry let's
take a little look there we are so you
can see the eardrum there obviously
we're not expecting our eardrum to look
perfect it had so much of that skin
debris attached to it and around it but
that will hopefully now know we take
another way it's sauce fingers crossed
that will regenerate normally we'll just
have to see I'll see whether it's the
patient normally comes through with kind
of more ear wax issues than skin issues but
you can see it obviously has built up
quite nicely so it's the same patient
second year now so we're just using the
forceps just to clear some of this
harder skin debris away first of all so
cameras just misting up a little bit
there it's just very warm in this
gentleman's ear canal so it's just
causing a little bit of a mystic in the
room was a bit cold so the camera was
just missing up a little bit so you can
see we're just working this larger piece
here it's quite stuck to the ear canal wall
on the left-hand side so I just want to
try and detach so you can see this the
adhesion there with the skin layer
underneath just trying to detach this
from the dry skin underneath because
that's what's holding this in place at
the moment so just slowly working this
down the ear canal just trying to get a grip
on it you can see that that skin is
really holding this in place so because
we've got a large enough gap now it's
far enough away from the eardrum this is
where a st. Bart took will come into
effect so we can just pull it down here
get rid of that and then we'll do the
same then just on that bottom section
you can see where me about pulling
straight through sometimes when you use
the hook on these kind of pieces of
ear wax because it's such a thin end to it
which it has to be to get behind this
ear wax it just doesn't give enough traction
you can see it just ripping straight
through the middle of this all dry
skin really so just slowly work in this
down the ear canal out of the ear canal
there we go just pulling it very slowly
down maybe I can see it there and then
let's just see just Rock just using the
edge of that the same box okay just oh
just a roll it basically down the ear canal
let's go in with the Jobson horn which
will give us a bit more traction to this
ear wax because of the shape of the horn
you've got this spoon end it just means
you'll get a better grip on the ear wax and
skin so as it's coming down there you go
you can see the difference as you're
pulling this with the Jobson you can see
because it's got a slightly wider end to
it you get a lot more coming out than
you would with that with the same Bartok
there you go and let's take a look you
need a little bit of dry skin there to
the left-hand side so I'll take that
away now there you go so that's coming
away nicely so if you know some people
in the background I mean click today
recording this so these next patients
outside so just slowly working this down
the ear canal just coming away there really
nicely
that's lovely that's coming away and so
there we go
let's get that section away as well
perfect a little bit more there at the
base of the ear canal so we just need a bit
of microsuction just to clear this away a
minute just lifting off the ear canal walls
there we go it was a nice dry piece
coming away there so from the base of
the ear canal so that's coming away nicely
all stuck in the ear canal wall maybe out
and there we go we can see the eardrum
now all nice and clear on this side
so this is what we removed altogether so
you can see it's quite the first sort of
left-hand side of the ruler there was
what we removed from the first year and
you can see it comes all the way
along so we're about five inches
altogether 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
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