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15 year old having fatigue, mouth breathing. Allergic to pets and dust. Enlarged adenoids. Surgery advised. Second opinion?

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ENT Specialist
Practicing since : 1991
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My son is 15 going to be 16 on Friday. He has been feeling sick for storage 8 months. I have taken him to the dr. And he has gotten antibiotics that seem to make him feel better for a few days. He has been extremely tired and I noticed him mouth breathing. So we took him to an allergist. He is allergic to horses, cats, dust, dust mites. He is on meds now for the allergies. I then took him to myENT dr. She scoped him and was alarmed at how large his adnoids are and wants to do surgery. Could this cause my son to be so sick he can't get through school during the day? Can't do normal activities? Feels flu like?
Posted Mon, 7 May 2012 in Asthma and Allergy
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. Adenoid hypertrophy normally occurs between the ages of 3 to 7 years. Then it subsides and usually disappears by the age of 12 to 15 years.

2. Persistent adenoid tissue may cause the symptoms you have mentioned above, and more. Lack of enough oxygen causes fatigue and a sick feeling. An accompanying sinusitis can lead to the flu like feeling.

3. I recommend that you get him to undergo a plain computerised tomography scan of the paranasal sinuses (CT PNS) and a Sleep Study to rule out other causes for nasal obstruction such as a DNS (Deviated Nasal Septum), hypertrophied nasal turbinates, chronic sinusitis, palatal problems and tongue fall. I would also like to enquire about his weight.

4. I also recommend that you should start with a trial of medication since he has allergic symptoms. A combination of an anti-allergic and a leukotriene antagonist (like monteleukast) with a steroid nasal spray and regular steam inhalation for two weeks should be given.

5. Depending upon his response to medication and his scan and sleep study finding, treatment may be planned. You may share his test results here. There are newer options such as endoscopic microdebrider assisted, radio-frequency and coblation assisted adenoidectomy. Microdebrider assisted trans-nasal endoscopic adenoidectomy is prone to more bleeding.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

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