Paediatric ENT

Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon, specialist registration in Otorhinolaryngology, Head & Neck Surgery.

Children are not simply small adults when it comes to ear, nose, and throat conditions. The anatomy, the conditions encountered, the clinical presentation, and the surgical considerations are all meaningfully different — and the consequences of undertreated childhood ENT disease are more significant than is often appreciated. Persistent hearing loss from glue ear can delay speech development. Untreated obstructive sleep apnoea can impair cognition, behaviour, and growth. Recurrent middle ear infections can cause permanent hearing damage.

Dr Jason Roth (MED0001185485) sees paediatric patients for the full range of general ENT conditions alongside his adult ENT and facial plastic surgery practice. He treats children of all ages — from infants with glue ear through to adolescents with tonsillitis or a deviated nasal septum — and operates at accredited private hospitals experienced in the care of paediatric surgical patients.

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Common Childhood ENT Conditions

Select a condition below for detailed information.

Ear Conditions

Glue Ear (Otitis Media with Effusion)

The most common cause of hearing loss in children — fluid accumulating behind the eardrum without infection. Affects speech development, learning, and behaviour. Most cases resolve spontaneously; persistent bilateral glue ear with documented hearing loss is the standard indication for grommet insertion. Covers pathophysiology, developmental impact, cholesteatoma risk, natural history, and treatment evidence including adenoidectomy benefit.

Ear Infections in Children

Acute otitis media affects 80% of children by age three. Covers Eustachian tube anatomy and why children are more susceptible, the mechanism of infection, symptoms in infants and toddlers, natural history and watchful waiting evidence, antibiotic indications, recurrent infection thresholds for surgery, and serious complications including mastoiditis.

Grommets (Ventilation Tubes)

One of the most commonly performed surgical procedures in children. A small tube placed through the eardrum ventilates the middle ear, restores hearing immediately, and reduces infection frequency. Covers all indications, short-term and long-term tube types, the surgical procedure, water precautions, expected duration of function, recurrence rates, and risks including persistent perforation.

Hearing Testing in Children

Hearing assessment in children uses age-appropriate techniques — visual reinforcement audiometry (VRA) from six months, conditioned play audiometry from two and a half years, and standard pure tone audiometry from approximately four years. Covers how to read an audiogram, tympanometry, OAEs, and the role of ABR in infants and children who cannot participate in behavioural testing. Northern Beaches Audiology is co-located with the practice.

Nasal Allergy in Children

Allergic rhinitis is common in school-aged children and contributes significantly to glue ear, mouth breathing, disturbed sleep, and poor concentration. Treatment with nasal steroid sprays and antihistamines reduces adenoid size, improves Eustachian tube function, and can reduce the need for surgery. Allergy testing and immunotherapy are available through referral to an allergist where indicated.

Nosebleeds in Children

Most childhood nosebleeds arise from Little’s area on the front of the nasal septum and are precipitated by nose-picking, nasal dryness, or incorrect nasal spray technique. Most can be treated effectively with clinic cauterisation under topical anaesthetic — a brief, minimally uncomfortable procedure. Covers correct first aid, when cauterisation is needed, and prevention.

Nasal Foreign Bodies

Children occasionally place objects in their nose. Most can be removed in the clinic after the nose is decongested and anaesthetised. Button batteries require urgent removal within 24 hours — the electrical current causes severe mucosal burns within hours. If a button battery is suspected and cannot be promptly removed in clinic, attend a hospital emergency department without delay.

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Throat & Sleep Conditions

Tonsils & Adenoids

Tonsillectomy and adenotonsillectomy are among the most commonly performed ENT procedures in children. Indications include recurrent tonsillitis (meeting Paradise criteria), peritonsillar abscess, obstructive sleep apnoea, and chronic tonsillitis. Covers Waldeyer’s ring anatomy, the surgical procedure, day-by-day recovery guide, the haemorrhage risk window, and dehydration warning signs. Adenoidectomy alone addresses adenoid-related glue ear and nasal obstruction.

Snoring & Sleep Apnoea in Children

Paediatric obstructive sleep apnoea causes measurable neurodevelopmental deficits — attention, memory, and learning — and is a significant cause of misdiagnosed ADHD. Growth hormone is secreted during deep sleep: OSA disrupts growth in some children. Covers the full spectrum from primary snoring to OSA, all causes, the OSA-ADHD overlap, AHI grading in children (stricter than adults), and treatment options including adenotonsillectomy, CPAP, and orthodontic approaches.

Post-Operative Care — Tonsillectomy (Children)

Parent-focused post-operative guidance following tonsillectomy and/or adenoidectomy. Covers pain management (regular dosing, oxycodone syrup instructions), dehydration warning signs, the normal white healing membrane, snoring changes, school return timelines, activity restrictions, and the bleeding emergency criteria with after-hours contacts. The most important instruction: keep up fluid intake even when it is uncomfortable.

When to Seek a Paediatric ENT Assessment

A GP referral to an ENT specialist is appropriate for children with any of the following:

Ear

Hearing loss or delayed speech development
Glue ear confirmed on tympanometry
Three or more ear infections in six months, or four or more in twelve months
Persistent ear discharge
Suspected perforation of the eardrum
A failed newborn hearing screen

Nose & Sinuses

Persistent nasal obstruction or mouth breathing
Recurrent sinusitis (more than three episodes per year)
Recurrent or difficult-to-control nosebleeds
Loss of smell
Suspected nasal foreign body

Throat & Sleep

Habitual snoring (three or more nights per week)
Witnessed apnoeas or gasping during sleep
Significant behavioural problems, inattention, or suspected ADHD — sleep assessment is warranted
Recurrent tonsillitis meeting the frequency criteria
Peritonsillar abscess
Unilateral tonsillar enlargement

Anaesthesia in Children

One of the most frequent questions from parents relates to the safety of general anaesthesia in children. Modern paediatric anaesthesia in accredited facilities with experienced paediatric anaesthetists is extremely safe. The risks of a general anaesthetic in a healthy child for an elective ENT procedure are very low — substantially lower than the risks of undertreated obstructive sleep apnoea, recurrent infections, or persistent hearing loss.

Dr Roth’s specialist anaesthetists — Dr Andrea Santoro and Dr Paul Williams — have specific experience in paediatric and ENT anaesthesia and will contact families before surgery to discuss individual preparation. The anaesthetic assessment includes review of any previous anaesthetic experiences, current medications, recent illnesses, and any family history of anaesthetic complications. Children with a mild cold can often proceed safely; those with significant lower respiratory illness or high fever may have surgery deferred.

About Dr Roth’s Paediatric ENT Practice

Dr Roth sees paediatric patients from infancy through to adolescence for general ENT conditions at his Dee Why consulting rooms. He operates on children at Wyvern Private Hospital (Terry Hills) and North Shore Private Hospital (St Leonards) — both accredited facilities with appropriate paediatric nursing and anaesthetic support.

A referral from your GP or paediatrician is recommended before attending. For families whose GP has identified a specific condition, please bring any relevant reports, audiograms, or imaging to the first consultation.

Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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