This blocked ear wax removal extraction procedure is performed by UK pioneer and world-leading endoscopic ear wax removal specialist Mr Neel Raithatha (Consultant Audiologist) aka 'The Wax Whisperer’ at his clinic in Oadby, Leicester, UK. Ear wax removal is necessary when ear wax build up becomes impacted. Symptoms causes by earwax blockage include: earache (otalgia), conductive hearing loss, blocked ear, vertigo, tinnitus, itchiness and irritation, occlusion etc.
The client attended with Keratosis Obturans in the left ear. Her symptoms became noticeable over the last two weeks or so. She was quite anxious, especially of the ear hook, jobson horne, and crocodile forceps. This was for the reason that she previously experienced a perforation of the right eardrum after a school college pushed a pencil inside her ear.
It only became apparent the client was suffering from Keratosis Obturans during the early part of the procedure. Keratosis Obturans can look very similar to earwax, but it is the spongy-texture and extremely strong glue-like skin adhesives to the ear canal which make it apparent. In addition, people with Keratosis Obturans often bleed and have erosions of the bony canal wall. This is because the dead skin that makes up Keratosis Obturans becomes infected. For this reason, people suffering from Keratosis Obturans require regular check-ups of their condition.
This was a most challenging and extreme case. I began with endoscopic ear suction before reverting to the ear hook, jobson horne and crocodile forceps. The client was very anxious when using these instruments, for the reasons explained earlier. I managed to slice through some of the Keratosis Obturans, but the core was extremely hard, almost stone like, which can be another characteristic of Keratosis Obturans. Also, the outer layer of Keratosis Obturans is often sponge-like and these instruments are therefore not always effective as a result, as they simply tear small pieces of the dead keratin. In the end I instilled sodium bicarbonate on a couple of occasions, the second for almost 20 minutes to really allow the drops to penetrate.
Even then, the Keratosis Obturans was very challenging indeed to remove. Removal can almost be like a tug of war, as you are trying to extract the Keratosis Obturans which is spongy and elastic and stuck to the canal wall. I also compared it in my video to a piece of chewing gum that is stuck and dried to the bottom of your shoe.
The client found it uncomfortable at times to remove. I was at one stage considering referring the client of my colleague, Mr Darius Rejali, who is an ENT Consultant Surgeon, as he could inject local anaesthesia and numb the ear prior to removal, which may have helped. In the end, I was able to leverage the Keratosis Obturans to the entrance of the ear canal, before using crocodile forceps to extract it in one single piece.
The client has been referred to ENT as she may require a CT scan due to the bony erosion visible on the inferior-anterior aspect of the ear canal wall. In addition, she will require regular check-up as previously mentioned.
I hope this video, along with the client reactions, especially during the moment where she was experiencing some discomfort and pain, inform and educate the viewer of the complexities working within the ear. Too often, subscribers with limited knowledge or appreciation make comments, such as use this instrument, or that instrument, without understanding it is not as simple as that for one reason or another, as I hope I have illustrated both in the video itself and description.
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