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18/01/2026

Decision
They are not happy. i could sense that.Neither i. They have come for an opinion ,it seems. The boy, their only child is having occasional nasal block. He is only 6 years. He is very active and pleasant. "Is there any mouth breathing?". "some times" mother said."What about snoring?".Father is not sure. Mother again said "Yes".She also said his teeth are protruding"..
I put the Xray on the viewer. Adenoid is occupying around 60% of airway. Both father and mother has almost round face. The child 's pre-maxilla is protruding and almost an oval face. "Why didn't you opted for adenoidectomy operation earlier?".
"Doctor, he had frequent cold and rhinorrhoea. We did consult an Ear nose throat specialist. He advised that, adenoids though a little big can wait, as it may decrease in size. Since then we are on steroid nasal spray".
Steroid nasal spray for adenoid hypertrophy is one thing i am not sure. "Regarding surgery, at present i will not say it is a must".I said. "How ever his symptoms might be relived fairly enough. Over all facial development also will be modified"
Some times decision taking is hard.

24/12/2025

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Adenoids and When Surgery Is Needed

If you ask me whether adenoids should be operated or not, there is no single yes-or-no answer. Surgery depends mainly on symptoms.
But you come to me -a doctor, because something is bothering you, That symptom whether mild or severe—matters. May be like noisy breathing, constant runny nose (rhinorrhea), mouth breathing.

Adenoid is a normal structure. It is collection of lymphoid tissue located at the back of the nose,
It grow largest around 4–6 years of age. Then they normally start shrinking. After 10–12 years adenoids remain very small or disappears. In a small percentage of people, adenoids may persist into later life.
If there are no symptoms, no treatment is needed
You may ask what if symptomatic but not treated. Suffering is there like nasal block, occasional ear pain and disturbed sleep( even obstructive sleep apnoea) . Protruding crowded upper front teeth is not uncommon .May develop an Adenoid facies.
Medical treatment can be tried with nasal decongestant or steroid nasal sprey. But the large hypertrophied Adenoid mass may not subside.
There can be a silent complication like glue ear and deafness (secretory otitis media)
So if there is glue ear or Adenoid facies or obstructive sleep apnoea I suggest Adenoid surgery.
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