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.

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UK time so please consider subscribing hi everybody this is Rhys Barber from audiology associates thank you very much for watching our ear wax compilation video today we have three patients in this video so this first patients come through with reduced hearing on just on one side we can see some very very hardened up ear wax here at the entrance to the ear canal and what we're doing at the moment is just loosening this ear wax away what you'll see at the the base of the ear canal just below the microsuction – you will point out for in a second is actually a piece of dried blood so what they've actually broken the blood vessel here at the front end of the the ear canal which is going to become a little bit more important a bit later on so what we're going to do here is loosen from the sides now as we loosen this drier harder ear wax what you can see is that we've got a much wetter substance just below the ear wax or underneath it so you can see to the left-hand side of that ear wax there and these long stringy bits of wet skin coming away so this out just drier section here has been trapping what I think is it what looks like a tight 2/6 earner behind it so we're going to need to take this away to get a good look at it you can see there that white fluffy dead skin with a total 16 you get this milky kind of discharge coming away from the ear canal walls as well just to the irritation just taking away some of this dry abyss now the reason that blood vessels became a little bit more important there's a piece this is actually dry skin at the base of the ear canal underneath this section here which is firmly attached to that skin right on top of that that kind of burst blood vessel so if I go pulling that away it's gonna cause bleeding so I'm leaving that they for the time being and I'll get a good look at a bit later on you can see this wet skin material coming away here I take the six June is a kind of bacterial infection basically of the outer part of the ear canal so irritation to the ear canal you do telling a lot of discharge with it and what you can see here is all this dead skin coming away you can see it just does it looks really aggravated in here one of the complications you can get with a total of 16 it is you can get it starting to actually degrade the skin and it can actually start to start forming some kind of more granular tissue and what we're doing here is just taking some this wetter debris away you can see a couple of little red marks and they were talking point up for you in a second just how long ago they got this little bit of dry skin just to see how firmly attached this is but it is solidly on top of that blood good burst blood vessel so I'm going to leave that well alone you can see the wetter material here so I'm just going to start just taking some of those bits away so I can get a good look at the skin underneath if it is the type of a otitis externa that degrades the skin it can actually get into the bone as well so it's quite nasty now you can see some red marks there where the skins come away and it's exposing the kind of blood blood vessels underneath I think this is possibly a kind of a necrotising a type two six two net so we sent this patient along to their GP to get a referral into the ear nose and throat Department this needs to be treated with antibiotics and as a matter of kind of a urgency really this is our second patient here you can see we've got some skin tissue here just covering the entrance to the ear canal you can see the sort of flaps of skin they're covering over some ear wax behind it so we're just going to use the micro section here to get this get this out just come into contact with the skin you'll see the whole lot there we are so you're peeling away is one continuous piece there we go so a nice big chunk of skin covering the entrance that guy you can see where it was attached to the right side there but trapping quite a large section of ear wax behind it we're just going to remove the ear wax now and we've got some dry skin here to the right side so we'll just take that away here we got lovely and there's the eardrum looking nice and healthy so quite a simple extraction that one you can see the same kind of problem here on this side basically this patient had come in with just reduced hearing a feeling of fullness they have had ear wax removed in the past so they knew the sensation we've just got a large chunk of ear wax on this side a little bit of skin around the outside edge we can see just breaking away there so we're trying to get hold of that central section here we are you can see that coming away quite nicely a large chunk is quite a bit more still in here so we're just going to take weeks that flap of skin there just start taking some of this away getting to that large piece of ear wax at the base there of the of the ear canal as the front dents left a little bit in the entrance to the ear canals we'll grab that in there as well here we go and we've got a couple little dots of ear wax on the ear canal so we'll just take some of these dots of ear wax away last little section there can be away as well there we go and there's the eardrum a little bit dull so possibly a little bit of fluid behind there so this is what we removed from both ears you can see but for now centimetres just under two inches so come up to our last patient Denis compilation now this gentleman is quite a regular ear wax builder he's been Caesar once or twice in the past quite blocked at hard sections of ear wax on the outer part of the ear canals here so just going in with a bit of microstructure now this quite an angular chunk at the front end of this ear wax know you know from previous videos that it's easier if we've got those flatter piece to work on this one's quite angular it's also very dry which means that it's not always the easiest to get a really good microsuction grip on so what I'm doing first of all is just trying to loosen this off the ear canal wall sometimes we can get in just enough of a grip and with a bit of a wiggle it'll start moving down the ear canal which is what's happening here but there's a little flap of dry skin at the top of it which is just causing a few problems so just gonna tray in get a grip on that take that away if possible there we go so now we can see a little bit more of the top end of the ear wax we can get a better idea of where this is gonna wiggle its way out of the ear canal you can see it's not quite it's moving a little bit it's moving very slowly down the car but not quite enough as we'd like so we're gonna use the crocodile forceps now just to get a grip on this and see if we can pinch it either side so that we can yeah so we can just get a grip enough of a grip to pull it forwards this simple X tends to be harder you know so but it's soft there you go you see it's soft in the centre which means it's not the easiest to get the grip on and what we're going to do if we carry on using the foresight was we're just going to break a whole big chunk of the front end off so we're going to go in with the Jobson horn now I need to bring this forwards but also angle it to the right-hand side because if you bring it straight out it's gonna bump into the outer part of the ear and you're gonna not gonna be able to get the angle to get it out so I'm just trying to bring it forwards just working it down whew see I'm always going to the same kind of position in the ear canal so not too deep but bringing the ear wax forwards and then going back into the same position and bringing it forward again and just it just helps to slowly work it out without digging too deeply in there quite a big chunk there let's take a look at the eardrum here we are there's the eardrum or looking nice and healthy patient has exactly the same problem the other side but the watch is a little bit softer on this side so it means that although there's an angular front-end to this ear wax when we get a grip on it with the microsuction the microsuction will pull into the ear wax a little bit more musically we get that slightly better grip so you can see it's moving a lot more when we get the microsuction onto it so what I'm doing here is just wiggling working it up and down just there you go trying to work it out the ear canal you can see that as I'm bringing it out I'm trying to push it to the left side there you go trying to move it out from against the ear canal wall on the left side but it's a bit too long to get out so what I'm going to do is go the jobs in horn just get above it and push down and into it there we are and that's ruling out there now quite nicely get it all the way out maybe yes it's nicely quite a large trunk there as well and there we are is the eardrum all looking nice and healthy so these are the two pieces room also about a centimetre each you very much 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 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