Brief Answer:
Needs further investigation/follow-up before surgery. Try medication first.

Detailed Answer:
Hi,

Thank you for your query.

1. Get an Impedance Audiogram (Tympanogram) done. An X-ray Skull lateral view for adenoids should be done. Please describe the symptoms (besides the mild hearing loss) in detail.

2. Children whose symptoms (snoring, mouth breathing, frequents colds, running nose, ear infections, serous otitis media (SOM), adenoid facies, stunted growth and so on) keep worsening are considered for surgery only if medication fails to control their symptoms. While it is true that the the adenoids hypertrophy (enlarge) in all children between the ages of 3 to 7 years and then regress, most children do not require medication. They do tend to snore sometimes, with a few episodes of colds or ear symptoms.

3. Medication includes an anti-allergic, mucolytic (such as Syp. Relent), a steroid nasal spray, supervised steam inhalation / nebulization and occasional use of decongestant nasal drops (0.05% Xylometazoline) at times of severe nasal obstruction. Any medication should be under the strict supervision of your doctor.

4. It is important to get a baseline X-ray done. A lateral skull X-ray for adenoids can be repeated after a couple of months to check the regression of the adenoids, if any. Sometimes, the obstruction may be in the nose.

5. In the last few years, the requirement for adenoid and tonsil surgeries have reduced by about 50% or more as compared to earlier decades due to better medical treatment options now available. The requirement for ear ventilation tubes (grommets) can be decided on repeated tympanograms if there is no change after medical treatment.

6. Upload these test results and repeat them after a few weeks. You can upload these here or directly at bit.ly/Dr-Sumit-Bhatti

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

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