PEELING INFECTED DEBRIS FROM EAR CANAL AND EARDRUM – EP153


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.m. UK time so please consider
subscribing hi everybody this is Rhys barber from audiology associates thank
you very much for watching our ear wax removal video today so this
gentleman’s come through he’s a regular client of ours he suffers with repeated
ear infections and what normally happens is when we when he treats the ear
infection with antibiotics he gets left them with a debris a thin
film that sits all the way over the ear canal and over the eardrum which then
reduces the hearing so hearing is normal the rest of the time obviously with the
infection there’s a lot of aggravation or swelling in there or debris being
produced which then causes problems as far as general day-to-day hearing when
that gets cleared up then this film sits all over the ear drum all over the ear canal
which then also keeps the hearing reduced so what we’re doing at the start
here is just clearing the entrance to the ear canal so taking away any softer ear wax
debris basically around the outside edge what you’ll see in a second when we get
a little bit deeper it gets a bit easier to see as well is that there is this
film which is a mixture of the antibiotic drop that’s gone in drying on
the ear canal also any discharge from the infection that’s been left over any ear wax
that was in there all gets liquefied together and then solidifies on that on
the ear canal wall so very thin hard plates and films in here so to remove this what
we’re going to do is use the standard stays on a tube here and just lift at
the edges of the ear canal so you can see this film that I was talking about now
just lifting away from this left hand side ear canal wall here now what we’re
going to do with this to peel this away you need to just slowly work your way
down the ear canal lift it off the ear canal as you go now the difficulty with this
patient is because this covers all of the ear canal walls as we’re lifting you can
see it’s all pulling together into a large central section now obviously we
need to lift and peel from the ear canal also when we get this large central bit
here now we can’t wiggle left right up or down because we’re not going to pull
any more off the ear canal walls so we work down as far as we can and then we have
to go in with the crocodile forceps then so this is what you can see just coming
at a shot now as the crocodile fought up through a little bit to here now I’m not
looking to peel the whole thing away because we haven’t taken enough off the
ear canal walls with this what I’m looking to do is take away the excess I’ve
already peeled off so that allows me the end to work my way much deeper in the
ear canal and peel the remainder off the ear canal walls in the ear drum as you can
see we’re just taking the central bits away and you loose a bits around the
outside edge as this pit is here so you can see that’s all we’re doing is just
peeling around the outside which will then allow me to go back in with the as
on the tube to start lifting off the ear canal wall edges again so we’ve taken
away that central section and you’ll see what I mean now so as we go in now we
can start lifting look from the edge again and pulling up into the center to
take the next section way it’s difficult when the when you start peeling like
this at this bottom section here because you need to aim at the bottom of it to
lift it from the ear canal wall to get an effective peel that are breaking away
but what you’ll notice is when you go in with a suction I’m trying to aim for the
bottom of this but see it pulls that flap down into the suction so what you
get then is it’s really difficult to get to the section you need so sometimes
it’s easier to take that top section away with the crocodile forceps and then
get into where you need to be you can see this is just starting to break now
look along the outside edge and just trying to lift lift and peel you can see
we can’t really go too far now into either side so we’re just taking this
section from the top down peeling this away there you go
so I’ll just start to peel away a little bit more now now again a little bit
closer to the ear drum so just going to very gently start peeling
away from the top here now the top and left-hand side is actually just starting
to connect to the drum itself but the right-hand side is still connected to
the ear canal wall much further towards the camera tour away from the drum so just
see we’re just starting a little bit of a peel there to the top section so we’re
just going to go in there with the crocodile forceps again and like I said
just remove that outer piece Theory are so just taking that away so it doesn’t
keep flicking up in front of the section as we go in then to take away a few more
bits there you go so we’ve taken a lot of that top section away now it gives us
much better bit of this film to work on you can see it’s quite firmly attached
in there just peeling some of the left out I saw it towards the right hand side
from right to left now taking down the ear canal this right-hand side here we are
just peeling that now working our way down you can see it’s just starting to
peel away at the top working on the bottom tray and lift that up and working
across opposite sides at the moment because obviously the more I can peel
away and the more I can get down towards you know try and get it all to keep
together if we can peel all the sides away it means we’ve got a better chance
of the whole thing peeling off in one piece so obviously the last thing we
want to do is leave lots of little tiny bits on here because there going to be a
lot more difficult to remove and a lot more uncomfortable for the patient as
well so you can see it’s all still quite firmly attached we’ve got a couple of
leading edges there to work on now so crocodile forceps are going to go
back in just looking at pinching this bottom section there you can see how
difficult to this because the nose of the crocodile forceps is actually quite
wide so to try and get into these little gaps and hold on to these thin sections
can prove quite difficult sometimes you can see we’ve got another leading
edge there now so just working that peeling down you can see it all start
the peel away now always with the forceps and this kind of
thing it’s always gentle steady pressure so a nice smooth continuous movement
pulling down and out of the ear canal because if you make jerky movements with
this kind of this kind of film in here then it’s just gonna start breaking bits
off or you’re gonna put a lot of tugging action on to the actual eardrum itself
which you don’t want to do you want to gently peel away from it yeah you can
see it starting to come away you can see the film lifting look as we’re pulling
this top section you can see it’s bringing the next section forwards
allowing us to get underneath now above and below there you go so we can get a
much firmer grip on this section now there slowly and see it starts peeling
away in longer strips then when you can do this slow movement so what we have
now is some dry ear wax to the right side and also in the base of the ear canal as its
as its getting a little bit closer to the eardrum I can’t quite get the angle
to do an effective peel on the right side so I’m going to lift up from the
bottom because I think this is one continuous piece so you’ll be surprised
just to see just how much is actually hidden out of sight of the camera and we
talked a lot about this valley that’s just in front of the eardrum and this
will give you some idea of how much can actually accumulate in that valley and
how deep it is so we’ve taken in one section away now yes we’re gonna work on
the next section so you can just see that flicking up to the front there then
see it’s a long edge can’t quite get the grip I need using the finer end because
obviously it’s a much smaller aperture on a fine ends are very difficult to get
an effective grip so we’re going to use the crocodile for setup style just to
grab that piece trying to get hold of that very thin leading edge they’ve got
a grip on it and just pulling it’s just broken away so just gonna go back in get
another grip there we go there Kimsey so that was
tucked in that little Valley so you can see just how much was there there’s
actually more still in there so if we go back in there with the forceps and see
if we can grab that try not to go too deep obviously so we don’t touch that
eardrum you can see it’s a delicate procedure trying to grab the bits we
need but not touch the drum behind it they fold it and got a good grip now you
can see just how much is pulling away can you see all that coming away there
you asked we have peel the bottom and to the right and out it all comes in one
piece when we take that back in there there we are
there’s the eardrum and now obviously there’s a lot of bits of dry skin in
here but don’t forget this gentleman is prone to ear infection so I wouldn’t go
diggin against the skin in there I don’t to encourage another infection and
that’s what we removed thank you very much for watching our
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