hi everybody my name is Rhys Baba 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 video today a bit unusual in this one this
patience comes through following numerous syringe attempts to remove what
they thought was a little bit of wax and possibly part of a cotton wall ball
there’s been stuck in this patience here so as we start sectioning we can see
that we can see the white fibers Jess there’s they get sucked into the that
the Zollner tube so we know this is cotton wool on the outer part of the ear
canal the difficulty when you have cotton more like this sometimes is the
wax coats the outside so it looks like a blob of wax the it’s really difficult to
remove that with suction so we’re going to use the crocodile forceps to get a
grip on this so you can see out it pops but behind that was another cock mobile
so which is a bit unusual sometimes it does happen so we use down a little bit
of suction just to tease a piece of this cotton wall away from the main bulk of
it so we can go in there with a crocodile forceps and get a grip the
reason we do that is sometimes to get a grip you have to push into the cotton
wall ball which can push it further in so I like to get a piece off the edge if
we can so second cotton wool ball come away a little bit of wax on the end of
the camera and I can see that there appears to be more cotton wool so we
carried on using the micro suction just to take this away the gentleman was
aware that he’d use cotton wool to clean his ears but was a bit vague about the
detail so I’m not too sure whether this is the end of cotton wool buds or
whether it’s a cotton wool ball that’s been put in there but I know he’s been
having difficulty with his hearing for such a long time that I think what’s
happened is that he’s tried to clean as he is once with cotton wool and got it
wedged in there and then tried to use maybe caught more buds and cotton wool
again to try and clear this out just through sheer frustration
so we’ve ended up with lots and lots of cotton wool in here so we’re just
teasing another piece away from the main bulk of the next piece of cotton wool so
just taking this I started to lose count after a while of how many pieces we took
away I think from my count I think there’s about 12 in here between both
ears so just counting the larger pieces like kind of these sections you just saw
coming away there rather than a small straggly bits that we get away but yeah
I think it’s about seven from the one year and about six I think five or six
from the other ear sister yeah so let’s see what’s going on here so we’ve got
more strands of the cotton more coming away just gently teasing this away
sometimes you’re lucky and it comes away in rather large blobs but a lot of the
time what you get are these kind of slightly thinner strands detaching from
the main bulk here which is what we can see so just still using the cotton wool
ball there’s a little bit of dead skin around the outside edge there there you
go you can see that wrapped around because obviously where this cotton
walls been sat on top of the skin all the skin underneath is degraded the the
doctors were prescribing drops thinking this is a wax problem so you imagine all
those drops any oil you produce in the ear canal they’re sort of dead skin
tissue so they’re all soaked up by these cotton wool balls so it’s you know it’s
written quite quite aggravated in here and you can imagine just how
uncomfortable this would have been for the patient they really didn’t hold much
hope of me being able to get this out because they had so many failed attempts
with with syringe and irrigation that they really didn’t think we were going
to be able to clear but as you can see we’re working our way through it I’ve
got another thin strand coming away there
I mean this was you talking the ear canals about an inch long and this
cotton wall went from front to back so quite a bit and compressed together as
well so not all loose bits some of these pieces we took away would really
hardened up over time as well so this is you know probably a couple of years
worth of cotton wool has been stuffed in here so we don’t expect this ear canal
to look particularly pretty at the end of it because we’re gonna have with
loads of dead skin tissue in this or this this whole canal needs to dry out
after we finish but you can see another piece coming away there okay so we’ve
got to the end of it so we can just start to see the eardrum you can see
that it’s been pushed right up against the drum so we’re just going to clear
some of this kind of looser skin there you can see just it’s just been wet over
such a long time it’s just peeling away in layers there’s one thing I do want
you to take a look at we’re gonna put a circle on here in a second
because we had to stop for a bit because we start to see some flexion to the
actual drum itself as we were suctioning you’ll see it just underneath this
circle you’ll see it pop back it there did you see it pop back into place so
we’re gonna call it a day there we’re gonna stop on that ear and just let all
that dry out and all repair itself it should look absolutely healthy after a
couple of weeks but this is the second year now so same patient second year by
my count I think we took seven pieces of cotton wool out of the first year and
what I can see is we’ve got some wax here at the entrance to the second canal
so this is just plain old plain old wax here so we’ll get rid of that first of
all there we go and then behind that you’ll start to see
that kind of familiar white of the cotton wool again so there we are so
this you can see it looks like wax on the outside but this is actually a piece
of cotton wool here so really kind of pink underneath all this or really
aggravated canal wall here I think this patients been really kind
of jiggling stuff in there as well to try and free this up which is just
compacted everything so not not the most comfortable for the patient to have
removed either so we’re gonna have to go really gently with this so sticking with
the crocodile forceps now just trying to get a grip on a large pieces just start
to pulling a large piece towards the entrance to the canal new yep
hope that one pops so that’s the first cotton wall ball out now really based on
the other we are expected to see maybe one or two in here as well but you can
see here the redness the pinkness to the canal wall there just underneath the
suction tube the fact that the cotton wall has been so compacted in here it’s
actually pressed against the canal walls and formed perfectly to the shape of the
canals and just time to try and work my way around the edge at the moment just
to try and lift this up and you can see that the white dead skin there
underneath has been trapped underneath this cotton wall and you’ll see a bit of
mist into the camera and things obviously this cotton balls trapped
moisture and everything in here so the ear canals like really it’s kind of
quite humid with all this wet dead skin and all the drops have been sucked up in
here so you’re just getting with a misting to the lens on the camera there
every so often I’m just taking some dead skin tissue away there you can see
there’s a piece here at the attic so just pulling that bit down just draws a
little bit more the cotton ball out with it so going back to the section now just
to try and get a leading edge on this next piece of cotton well you can see it
was quite a lot up there in the the attics or the the ceiling of the ear
canal so as we pull you’ll start to see that
coming away so that’s the second cotton wall ball out just pulled the next set
of fibers forwards because it’s been compacted against the next sensor
there’s more cotton more than here again you can see just pulling the straggly
pieces away they’re back in with the section now just a tidy up get all these
looser fibers into a into a more kind of usable strand that can come away so we
get a better grip on it with the crocodile force app you can see they’ve
got a long strand now so we should be able to get a good grip on this with the
forceps there there you go it’s just start to pull away a little
bit just as we get the next section coming forwards so what we’re working on
here is the third cotton wool ball which is kind of breaking down I think as it’s
coming out there there we go so that’s the third one you
can see a little bit of blood there as well at the bottom where this has been
really jammed in here it’s it’s pressed against that can i wuold agreed in that
canal wall don’t forget the skin in the year canals
paper-thin it’s just a couple of skin layers thick and the blood vessels are
just below the surface so if you’ve got this aggravating rubbing back and forth
in there then it’s gonna be really you know you are gonna run the risk of
having some bleeding in here and just how far this is pushed into the canal as
well it’s it this is gonna be really uncomfortable for this patient I think
we’re up to that this is the fourth I think this is the fourth cotton wall
ball that’s coming out now there you go and behind that is more cotton wool you can see that next ball of cotton
more coming away there and behind that is more cotton wall so we’re still going
so I think that was the fifth that was the sixth there was a lot of blood
attached to that one which I’ll show you in a second you can see why because it’s
been pushed right up against the eardrum and actually caused the bleeding on the
drum and bruising there and bleed into the canal war so this has been jammed in
so far it had caused quite a lot of quite a lot discomfort these are the
pieces we removed so they’re not small pieces actually run out a ruler again
this time but you can see it there in centimeters patient was really pleased
to get this out here so much better afterwards
obviously we go there if this patient comes back to us just for a follow-up
we’ll pop that video on few sheet and see what happened just gives you some
idea of what we had to take away well if you did like again please like share and
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