OUTER EAR INFECTION TREATMENT & EARDRUM PEEL OVER 3 VISITS – EP 253


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 watching our video today I’m sorry a little bit different this time we’ve done fungal infection recently and lots of people asked the question about you know what was it like when people come back and so I thought what we do where the patient who came through the clinic with an outer ear infection so we’ve seen this patient on three occasions this is the first time I’ve seen this patient you can see we’ve got a very swollen ear canal the ear canal walls are really puffy they’re also very red aggravated inflamed very wet sticky thick discharge in the ear as well which is a mixture of the ear wax but also infected debris as well in here so what we’re going to show over that over this video is the three visits the patient has so it’ll give you an idea of the progression of the treatment of the ear infection so for this one the main job today we know the patient’s got an infection so my main job here is just a clear as much of this debris as we possibly can so that when the patient is using for an outer ear infection is usually a topical treatment so when the patient uses the spray to calm this skin down and to treat this infection it means that the spray itself can get to the affected skin underneath so I’m just taking away the sticky thicker debris here you can see there’s not a great deal Iram to work in here that’s actually a fine end we have on the end of the suction there so you can see that it’s not there’s not a great deal of space in there whatsoever so just trying to work as gently as we can but obviously if you could imagine ear canal walls are sensitive any way if you aggregate them and inflame them like this they are ultra sensitive so it we just try as best I can to avoid touching those ear canal walls this is the patient’s second visit so this is ten days later so the patients have treatment in here now for ten days it looks very wet they were using a spray treatment in here so we’ve now got a mixture of the spray treatment the infected debris and these are liquid more liquid ear wax so I can just try to uncover the ear canal walls first of all so we can get a look and see what the ear canal walls are looking like now as we start to clear you can see there’s some pinkness they’re not looking quite as red as it did in the last video so it is starting to take an effect but what you’ll see now as we start stripping this Way’s you’ll start to see lots of dead skin as well where the top layer see wares peeling away they’ve got this whiter layer underneath if you imagine the skin is wet constantly then you’re gonna get this whiteness of you ever had your hands in water for a long period of time you get this kind of white layer to the top of your skin that’s similar to what we’re seeing here so we’re just stripping this away at the moment very gently we can see the ear canal that some of the swelling’s gone down because this is the standard size on the tube we have in in in the ear canal at the moment so you can see gives us a little bit more room am i – I do have two bits of news fear for everyone as well so I’m gonna wait till a bit later on to tell you those two things but we’re just going to keep just plugging at this a moment you can start to see the eardrum now so we’re going to go in with a fine end just to get a little bit deeper in because you’ll be working a little bit closer to the eardrum so you can see we’re lifting this liquid debris off the base of the ear canal here looking at the ear canal walls I know this patients gonna have to come back in and see us again what we do here is if a patient comes through with this type of problem with is an infection we automatically follow them up following their treatment now a lot of places done we like – I’ll explain why when you see the last visit in for the patient it’s pretty easy to explain to be able to see what we’re talking about but what I want you to bear in mind with this one seal wet this debris is at the moment it’s covered the eardrum so we just try to take some of this loose skin and debris off the ear canal walls here so it’s completely covered the eardrum a little very wet material you can see it’s very thick as we go a bit closer so you starting to peel away there at the top of the ear canal there we go what we’re going to want to try and do is uncover this a drum as much as I possibly can here because I’ll see the eardrum is skin so it’s going to get aggravated with this infection as well so we want the treatment to be able to get down to that layer as well now when it’s all blocked up and thick with debris like this is that the treatment can’t get down to where it needs to so you can see we’re just trying to clear a little bit off you’ll see a little bit of flexion there to the eardrum so we’re going to be really careful here just taking as much of this so you can see it it’s thick we can see the blue of the eardrum underneath which is great it shows when the eardrum hasn’t been affected too much I’m not going to really read puffiness to the eardrum which you can do with with some of these sort of saw the outer ear infections the term find out who your infections are take this externa which just means any kind of aggravation or irritation to the outer part of the ear you can see we’ve got still got some quite liquid thick debris deeper in just take another way I’ll get first bit of news I am on leave next week so there will be no videos next week I’m sorry but I am then back to normal the following week this is the last visit so you can what we can see now there’s the eardrum so you can see the swelling has gone down the skins will come on normal but see all that liquid debris we did have on the eardrum is now hardened so it’s formed a thick plate also coating the ear canal walls now this is the reason I like to have patients back in now this patient was explaining that they felt much better in their ears there was no irritation there now it didn’t feel as squelchy which is quite a common term that people normally use with it out through ear infection but they did feel that here and was still quite muffled now the reason for that is that liquid debris that’s been sitting all over everything is now hardened up so it’s actually thickened and formed at a very thin plate or layer over the ear drum which is hardened itself so what that means then is it’s very difficult to get the full range of movement to the eardrum so this is why I like to follow these patients back up it’s because then we can go back in and as you can see here all of that infected debris all of the treatment that’s been going into these ears is now dried into these much harder pieces so we’ve introduced a little bit of olive oil in here which is going to help us to peel this off the ear canal walls so while you’re just watching that the second bit of news we have for you is we have another audiologist starting in a few more weeks time which is absolute front it was super excited it means that we it’s going to free us up a little bit to be able to concentrate a lot more on things at YouTube now social media and stuff of that so thank you everybody for being so understanding and bearing with us over the last few months it’s gotten crazy busy here which is which is fantastic but it is does mean with somebody else on board as well covering some of the sections it’s going to help us to really concentrate and get more content out there for you guys as well so you can see we’re starting to peel this away and it’s starting to come away from the bottom the ear canal these are these are one of my favorite ones to do I love peels they’re the most demanding ones to do but they are by far the most satisfying ones I find will do this something really nice about it takes a really steady hand to do them but they’re one of my favorite ones to do so we’re just taking some more of this Deborah where you can see as we’re uncovering the skin in the you can I’ll see you have far more healthy beige color we just got this little bit of debris here at the top of the ear canal now normally when I’m doing a peel like this you normally pull down as far as you can this patient has a more difficult ear canal to working because you can see rather than it being a circular shape we’re more of an oval tilted on to its side so you get a lot of kind of top right to bottom left movement but not a great deal up and down which means that when you’re peeling from the the roof of the ear canal they’re sort of like the attic regions what we like to call that what you end up with then is you don’t have a lot of space so we have to kind of peel across or left them back across from right from right from left to right them back across and right to left so we’re using the crocodile forceps here just to see if we can do a gentle peel down and across there we are that’s taken that away cuz it’s easier to pull that backwards motion whereas the suction wouldn’t have held onto it as tight enough first real to do that and now we’re lifting the bottom section is you can see we’re working slowly down to the eardrum see how much healthier that skin looks though there’s a slight pinkness there yes there is this has been sat on top of it so it’s been not aggravating this such but you know it hasn’t got that kind of normal beige appearance but you can see just how hard and thick this is what I’m trying to do here is I’m trying to look for a flatter section of that like so they can get a really good grip on but I’m struggling a bit to get a really good grip so what I’m really use is the crocodile forceps again it’s not the easiest piece to get a grip on because it’s sideways on and we haven’t got a great deal of room to open the forceps up in here you can’t it’s difficult to get around to the front end of this ear wax and debris sorry I should say so I’m trying to pinch it in the middle if we can to fold the top back in so we can get it there we are now we’ve got the grip I want to get this piece because it’s quite a large pieces you want to get this out of the way there we go and you can see we’ve got the beginnings now of what’s coming down onto the eardrum so we’re going to peel this across you can see we’ve got more room if I peel from top right to bottom left there you go see it’s starting to peel away now and so that’s the top section coming away we need to get this set you could see how Brown that eardrum looks there it’s completely caked and as we peel this away you can see it’s starting to come away from the eardrum starting to come away from the ear canal walls we’re getting that pinkish skin look there at the top underneath flattening it out trying to get a good grip on that back section there peeling across and out there we go now when you take a look at the edge and can you see the blue or color starting to come through now you’ll see I’m gonna work on this flap this about halfway up here you’ll see that blue tinge coming through now so we’re starting to break this away what I’m doing here it’s such a fine piece I can’t press in two exits on the eardrum so what I’m gonna have to do is flick it out so that it’s facing directly towards the endoscope and that means then if I can get it pretty much straight on I can get the crocodile forcep on it to take that away there that or I’d flip back you difficult with a suction because you’ll pull it so far and then it’ll flip back into place you’ve got it straight this or what I’m looking at you’ll see what I mean by getting the crocodile four so now it’s pointed straight towards the endoscope whereas straight down with the forceps we can get a good grip heeling away there we go you can see that chunk so that’s taken it off the top of the eardrum there now okay this is where it gets really delicate you can see I’m just taking the glue what we’ve got here that this the Deborah’s come with a very thin layer coming away so we have to press into the ear canal walnut this is really sensitive so I always explain what I’m going to do before you put in the argh enough experience a bit of a pinching scratching I’m trying to lift here off that ear canal wall you’ll see why because if I can get a lift there see that see that top section and bottom section are connected together we can get a good or just flip back in place we can get a good movement there you can see the olive oil working down behind it now but look what’s half this sheared away and can you see that pieces flick back so there is a trick for doing this what I’m going to do is I’m going to use the suction not the end of the suction tube to lift it watch what happens here you’ll see it flick up with the suction this you just on the lift from the ear canal wall they got it so we’re not touching the ear canal wall at all we’re using the suction to bring that up towards the end of the tube we can get a good grip on the back end of this now really trying to peel from left to right now across here you can see where the olive oils gone in it started with behind it start this you go remember this is so thin that it’s quite common for it to shear there now we’ve exposed that left-hand side of that the drum I’m going to train to the same trick now with the suction at the bottom here to only lift it but I think this is too far back we’re not going to get a good lift here we’re gonna have to push into the ear canal wall a little bit always going to be very careful can our walls can bleed if you push too far into them here we go we’ve got the lift we wanted just got a grip on that edge peeling across to the right side also have showed me the microphone there we go and then we’re going to bring this section back now there we go good peel there from the ear canal wall and you know the patient fair play they sat through so much to go through this Fillion Fitness to them but by this by they they kind of we were gonna try and take this last little piece of we could away but patient had enough for that point so this is what we removed and this was just from the last visit so this is all those skin peels you can see quite a bit there was coating that ear canal wall just after this I’ll show you the difference from when they first came in we should pop up in a second there we are so that’s where look like when they first came in and that was out the the first visit and then that’s what they looked like by the time you can see the difference there in the ear canal you very much for watching our video today if you did enjoy the video then please like if you’d 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 updated now if you want to follow us you can do 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42 thoughts on “OUTER EAR INFECTION TREATMENT & EARDRUM PEEL OVER 3 VISITS – EP 253

  1. Loved your video today. Getting close to the ear drum always makes me tense, but you always succeed in close cleaning! Great job πŸ‡ΊπŸ‡Έ

  2. That was absolutely incredible!!! What a great video and satisfying to watch as all of your videos…. Enjoy your much needed and deserved leave next week with your lovely wife…

  3. My goodness. Difference was amazing. Skin peels are definitely my favourite. There is nothing more satisfying then watching those flaps of skin removed. I wish I knew why but I simply don't. Congratulations Rhys on your new team member. Enjoy your time off. Much love to the wife.

  4. This is the best video ever. I love it when the wax starts to peel away and then a big piece starts separating. πŸ€” I think I enjoyed this too much.

  5. What a great start to my day!
    (Eating a muffin and drinking coffee)
    Love that you helped them so much!
    Have a safe holiday!

  6. I'll miss you next week, but I hope you have a great vacation (holiday). Congratulations on getting your new audiologist! I can't wait to get to know him/her.

  7. Yay! So glad there'll be more help, maybe more videos? πŸ˜‰ Hope you enjoy your vacation, and thank you for another wonderful video πŸ™‚

  8. That was brilliant ! If I ever need ear treatment, guess where I’ll be going? πŸ˜‰ Down from Scotland too! πŸ‘πŸ»πŸ‘πŸ»πŸ‘πŸ»

  9. I would like more of this style – following a single patient's complex issue over multiple visits – whenever possible please. =)

  10. Hi Mr Barber, I meant ask what causes such a an infection like this, what a state this ear was in, very clever man you are taking all tat away, will miss you next week. Margaret x

  11. Tidy peel Rhys. Do any of your patients sneeze or cough when you do this procedure? when I've had my ear cleaned, It always makes me sneeze or cough when the left one is done! I do enjoy the appearance of the crocodile forceps πŸ˜€

  12. ok, stupid question alert……would it not be good idea to create a small rubber grommet or at rubber tip with a beveled edge to use at the end of the tube to prevent further agrivation to the cannal wall?

  13. That was so interesting – thank you for showing us the different stages. Congrats on your new Audiologist – best of luck to them & you. Enjoy your time off – you will be missed πŸ˜ŠπŸ‘‚πŸ‘‚

  14. Just wow. I've not seen ear infection before; it looks terribly uncomfortable. Thank you for explaining throughout the 3 day process. Enjoy your time off and congrats on your new colleague!

  15. Congrats on the new addition to the 'family'!
    That skin peel was EXCELLENT. Enjoy your time off, we'll all be ready and waiting for your return.

  16. I do love a good skin peel! It was amazing to see the difference between their first visit and their last too. Definitely a winning formula!

  17. Really really interesting to see a patient return twice and the difference in their ear. Enjoy your leave and congratulations on your new hire. I'm so pleased you're becoming popular enough to need one!

  18. Great work! It's nice to see the progress with the patient. Thanks for sharing! Have a great time on your leave and congrats on getting another audiologist! ; )

  19. I really like your thoroughness and professionalism in doing your work! Congratulations on hiring your new audiologist and enjoy your time off!

  20. You are just amazing. And I wholeheartedly agree, skin peels are where the men are separated from the boys, and my gosh are they ever so… satisfying!…

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