hi everybody this is Rhys Barber from audiology associates thank you very much for watching a video today a little bit of a different one today this gentleman had a piece of skin that is just embedded in the ear canal there so just attach on the ear canal wall you’ll see how that happens a bit later on in the video because it does does make it a little bit clearer so the first thing we’re going to do is grab this this lump of skin that we can see at the entrance here with the zoellner tube so I’m just trying to get a grip on it just to train a little snit from the ear canal so obviously this skin is going to be attached somewhere in that inner ear ear canal not the easiest of bits of debris to get hold of with the zoellner tube the cars as we’re lifting it here what I can see it’s basically effectively a pocket of skin so we’re looking at the entrance of that pocket here so all of this around the outside edge is attached to the ear canal wall underneath and goes right the way down to the eardrum so what I’m doing is trying to get a grip on this but obviously with the suction it only has a limited amount of suction so we can hold on to it and try and wiggle it sometimes you’re lucky and the skin will break away from its source and you can take it in one big chunk but as what’s happening in this side I can get a grip on there but not a strong enough grip to to remove that so I’m just going to keep trying to see if we can loosen this away but you can see the pocket we were talking about you can see how far down as we pull that skin across to the right just how loose that skin is and how far down into the ear canal it goes obviously I prefer to use the suction to get this out if we can we can use the crocodile force out which we’re going to have to I think to do this so we got underneath just try and get a grip on that skin trained not to touch the ear canal walls as we do so but as what happens all the time with skin in crocodile forceps it just tears and it’s very difficult to get a really good grip on this because the skin is obviously sitting right on top of the ear canal wall we really don’t want to cause any discomfort for this patient so it’s just a case of being patient and taking little bits away at a time okay so we’ve got quite a large piece there and see what I mean by tearing it’s not really pulling out as we would have really liked it to do with one big pocket of skin so you can see that it’s peeled away now you can see the ear drum there but we can see there’s a lot more of this you can see that loose skin there like just peeling away this gentleman’s having to have his ears cleaned out he’s actually on holiday so he’s coming to see us today but he’s home dollars here cleaned out back at home every six to eight weeks so what we’re gonna try and do here is give him a really thorough clean so strip away as much of this old dead skin as we possibly can we’re going to see it peeling away all the way down here ear canal and see how far down that goes now we can see the edge and we know it’s not attached to the eardrum so we don’t have to be really gentle as we would if that was covering the drum as well you’re pulling away in these long strips so you see the right-hand side knows quite clear but you can see that whitening of the skin on the left-hand side so we’re just gonna do the same thing there to the left side just make sure we give this this Jen a really thorough and going to that peeling all the way down this happens in some people there’s no specific cause for it if you’ve looked at the video way explain about keratosis top trends you know the migration of the skin in the ear canal so this can just go you could just produce too much basically it just it just forms these layers of excess skin so I’m just trying to do a little bit of tidying up a bit closer to the drum so we’ve got the fine end on there now so yeah there we go just stripping away all the bits of trier skin there we’re never gonna get all of this away also we don’t have strip too many layers away because it it will start causing problems as far as you know the the skin underneath itself is concerned we don’t according it is in the skin or any bleeding so oh yeah also it got sucked into the machines are no shot on the against the ruler you can see all the bits floating around at the bottom of the tank there so that’s just suspended in water we’ve just flushed the Machine through well thanks again for watching today guys if you do like the video then please like share subscribe as always take care


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