Ear Procedures
Dr Jason Roth (MED0001185485) is a Specialist Otolaryngologist and Head and Neck Surgeon. Otolaryngology — commonly known as ENT — encompasses the full range of conditions affecting the ear, nose, throat, head, and neck. Ear conditions are among the most common reasons patients are referred to an ENT specialist, affecting children and adults across all age groups and presenting with an enormous range of symptoms and severity.
Dr Roth sees both paediatric and adult patients with general ENT conditions and has experience managing the full spectrum of ear problems — from common presentations such as ear infections, glue ear, and wax impaction through to surgical procedures including myringoplasty, grommet insertion, and exostosis surgery.
He consults from Dee Why on Sydney’s Northern Beaches and operates at North Shore Private, Castlecrag Private, Pittwater Day Surgery, and Wyvern Private Hospitals.
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The Ear — A Brief Overview
The ear is a remarkably sophisticated organ serving two distinct functions: hearing and balance. It is anatomically divided into three compartments, each with specific roles and its own set of conditions:
The Outer Ear
The pinna (auricle) and the external ear canal collect and direct sound waves toward the eardrum. The ear canal is approximately 25mm long, lined with specialised self-cleaning skin, and protected by the natural acidic environment of earwax (cerumen). The outer ear is the site of conditions including otitis externa (swimmer’s ear), earwax impaction, exostoses (bony growths from cold water exposure), and foreign bodies. Disorders of the outer ear cause conductive hearing loss and ear pain.
The Middle Ear
The air-filled space behind the eardrum (tympanic membrane), containing the three hearing ossicles — the malleus, incus, and stapes — which transmit sound vibrations mechanically to the inner ear. The middle ear is ventilated and drained by the Eustachian tube, which connects it to the back of the nose. Middle ear disorders include acute otitis media (middle ear infection), glue ear (otitis media with effusion), eardrum perforation, otosclerosis, and cholesteatoma. These produce conductive hearing loss, ear pain, discharge, and pressure symptoms.
The Inner Ear
The fluid-filled cochlea (for hearing) and the vestibular labyrinth (for balance) are housed within the temporal bone. The cochlea contains approximately 15,000 sensory hair cells whose vibration generates the neural signals transmitted to the brain by the auditory nerve. The vestibular labyrinth comprises three semicircular canals detecting rotational head movement and two otolith organs detecting gravity and linear acceleration. Inner ear disorders include sensorineural hearing loss (from age, noise, infection, or ototoxicity), BPPV (displaced calcium crystals causing positional vertigo), Ménière’s disease, and acoustic neuroma.
Ear Conditions and Procedures
Select a condition or procedure below for detailed information.
Insertion of Grommets (Ear Tubes)
Grommet insertion is one of the most commonly performed surgical procedures in children. A small ventilation tube is placed through the eardrum under general anaesthesia, allowing air to enter the middle ear space and fluid to drain. It is most often used for persistent glue ear or recurrent acute otitis media causing hearing or developmental concerns.
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Glue Ear (Otitis Media with Effusion)
Glue ear is the accumulation of thick, sticky fluid in the middle ear behind the eardrum — the most common cause of hearing difficulties in children. Many cases resolve spontaneously, but persistent bilateral glue ear can affect hearing, speech development, and behaviour, and may require grommet insertion.
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Ear Infections in Children
Acute otitis media is one of the most common infections in childhood, affecting 80% of children by age three. Understanding Eustachian tube anatomy, the natural history of ear infections, when antibiotics help, and when surgery is appropriate guides management for families and clinicians alike.
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Perforated Eardrum
A hole or tear in the tympanic membrane from infection, trauma, or barotrauma. Most small perforations heal spontaneously with ear protection and treatment of any infection. Persistent or large perforations causing hearing loss or recurrent infections may require surgical repair (myringoplasty).
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Myringoplasty
Surgical repair of a eardrum perforation using a graft taken from the patient — typically temporalis fascia or cartilage. Aims to close the perforation, eliminate recurrent infection, and in most cases improve hearing. A well-established procedure with success rates of 85–90% in experienced hands.
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Hearing Loss
Hearing loss is conductive (outer/middle ear), sensorineural (cochlea/auditory nerve), or mixed. Accurate diagnosis through audiometry determines whether treatment is surgical, medical, or audiological. Sudden sensorineural hearing loss is a medical emergency requiring urgent assessment and treatment.
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Hearing Testing
Audiological assessment — from pure tone audiometry and tympanometry to VRA for infants and ABR — is integral to the evaluation of ear conditions at all ages. Northern Beaches Audiology is co-located with the practice in Dee Why, providing seamless audiological services.
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Outer Ear Infections (Otitis Externa)
Infection of the ear canal skin, common in swimmers and those who use cotton buds. Microsuction cleaning of the canal is the critical first step — drops alone cannot penetrate infected debris. Prevention focuses on keeping the canal dry and avoiding any instrumentation of the canal.
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Exostoses (Surfer’s Ear)
Bony overgrowths in the ear canal from repeated cold water exposure, progressively narrowing the canal over years. Found in 70–80% of long-term surfers. Surgery (canalplasty) is performed when narrowing causes recurrent infections, persistent water trapping, or significant hearing loss.
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BPPV (Positional Vertigo)
The most common cause of vertigo — displaced calcium crystals in the semicircular canals generating brief, intense rotational vertigo with head position changes. Diagnosed with the Dix-Hallpike test and treated in the consulting room with the Epley repositioning manoeuvre. Success rate approximately 80% with a single treatment.
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Tinnitus
The perception of sound without an external source, affecting approximately 15–18% of Australians. All new-onset or unilateral tinnitus requires audiological assessment and ENT evaluation — tinnitus is a symptom with a range of causes, some of which (including acoustic neuroma) require MRI imaging to exclude.
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Ear Pain During Travel
Otic barotrauma from air travel results from Eustachian tube failure to equalise pressure during cabin pressure changes. Preventable in most cases with decongestants, equalisation techniques, and pressure-filtering earplugs. Recurrent severe barotrauma may warrant grommet insertion.
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Why See a Specialist Otolaryngologist for Ear Problems?
Many ear conditions are initially — and appropriately — managed by a GP. Specialist assessment adds value when symptoms are persistent, recurrent, significantly affecting hearing or quality of life, or when a surgical option may be appropriate. Otolaryngologists have specific training in microscopic ear examination, microsuction cleaning, and the surgical procedures required to manage ear disease. The equipment available in an ENT practice — operating microscope, suction, and specialist instruments — is not available in a general practice setting and is frequently essential for both diagnosis and treatment of ear problems.
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Specialist ENT Training
Dr Roth completed specialist surgical training in Otolaryngology, Head and Neck Surgery through the Royal Australasian College of Surgeons, with broad experience across adult and paediatric ear disease including surgery for chronic ear disease, glue ear, eardrum perforation, and exostoses.
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Paediatric & Adult Patients
Dr Roth sees children and adults with ENT conditions alongside his subspecialty facial plastic surgery practice. Ear conditions in children — including recurrent otitis media, glue ear, and exostoses in young surfers — are a significant part of the general ENT workload.
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Integrated Audiology
Northern Beaches Audiology is co-located with the practice in Dee Why, providing hearing testing, hearing aid assessment, and audiological management as an integrated part of ENT care.
If you have an ear problem you would like assessed, please contact the practice to arrange a consultation. A GP referral is recommended but not always required for initial 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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