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Child having reoccurring cold, cough and fever. Adenoid need to be remove. Should I go for medication or surgery?

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ENT Specialist
Practicing since : 1992
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Hello doctor
My 2yr 7 month child having recurrunt cold cougnh and fever . Pediatrics give her each time some anitbiotics shwe improves but after some time agian she get XXXXXXX problem . We have shown to ENT as per them her adenoid need to remove and ear tube has to be inserted . We have shwon to other ENT andas per him he give medicne Naxonex spary , cefaclor , relent and some enzyme tablet to reduce fluid in ear. And he say he is confident enough that this medice can reverse the problem so wait for three week and then if problem persist than only go for surgery . Cuurently his impedence test shows type b but as per doctor its temproray and will be alight after fluid got reduced.

Now i am confusiod and dont know what to i am afraid if we give medicen and nothing happen in next three week . Is this possible she might loos hearing permanantly if we wiat for three week and take a chane not to do surgery imediatlly

Please advise we live in gurgaon.
Posted Mon, 29 Oct 2012 in Ear, Nose and Throat Problems
Answered by Dr. Ravinder Sharma 32 minutes later
Hello I am Dr Ravinder Sharma ENT surgeon. On the basis of information provided it appears that your kid is suffering from Seretory otitis media with adenoiditis. This is also called as glue ear.

It is common in 2 to 7 years age group and results from the blockade of tube (eustachian) connecting ear with throat. Adenoid infetion or increase in size causes tubal blockade. Due to tubal blockade there is negative air pressure in middle ear which leads to collection of fluid in ear. This impairs sound conduction in ear and thus the patient may have deafness. It this is treated in time it leads to complete resolution of symptoms. If not treated in time it may cause deafness in children.

The treatment involves improving ventilation of ear and remove the cause of problem.
It is advisable to consider medical treatment for 4 to 6 weeks and then consider surgery. But saying that it will completely resolve with medical treatment is incorrect. I am not sure for how long the child is suffering from this problem (may be it was there for some time and you have attended doctor at a later date).
The treatment summary for this condition is as follows
1. If the fluid resolves in 6 weeks (tympanometry at 6 weeks shows A type curve) then adenoidectomy will be required to avoid similar episodes in future. Tubes in ear are not required.
2. If fluid is not resolving in 6 weeks time it is advisable to consider adenoidectomy with tube in ear (grommet in ear)
Preponing surgery is not the right way as it is the stepwise management for fluid in ear.
Early childhood is a very crucial time and even slight hearing loss can cause language delay. So it is better to think about a treatment and avoiding further such epidodes as ear is a vital organ and if left unattended it may cause hearing loss which can affect the child in long run.

I hope this answers your concerns. Feel free to contact me if you want further information about it
With regards
Ravinder Sharma
Above answer was peer-reviewed by
Follow-up: Child having reoccurring cold, cough and fever. Adenoid need to be remove. Should I go for medication or surgery? 40 minutes later
Her histroy is as below ;

She got episod of cold cough , sore throt three times in last 4 month is this due to adenoid or Seretory otitis media i am not sure .

She complian the ear pain frist time on 29 sep 2012 , so we can not sure how long she is having Seretory otitis media. Befor that she never complain ear pain , but i have read on internet that in ottis media can be without pain also

you said that "If not treated in time it may cause deafness in children" so what is time period . Is waiting for six week will not cause any problem. as one of ent specilist is recommending immedite surgery and one is telling to wait for three week . is there any way we can know how long this infection persisting . Is the teratment given by current doctor ( Mr ajit man XXXXXXX ) is correct .is any way we can talk.
Answered by Dr. Ravinder Sharma 49 minutes later
Hi Thanks for the folow up of your query

The problem of cold, cough and sorethroat is because of adenoids or tonsil and adenoids. Ear problem is a complication of adenoiditis

Secretory otitis media may or may not be painful. I would advise you for a check tympanometry at weekly intervals. If there is no improvement we can review it accordingly.

I would be happy to help you I this resolves this confusion. My mobile number is 0000. I am working as Professor in ENT at Subharti Medical College, Meerut. On telephone, I can advise you about the expected line of treatment. There are some variations in management when you talk to two ENT surgeons with different training as there are pros and cons for all the treatment options.

Immediate surgery is not the answer. Waiting for a week or two will not change the situation. Not taking treatment for say about 6 months or a year makes the difference.

I hope this answers your concerns. Feel free to contact me if you want further information about it
With regards
Ravinder Sharma
Professor ENT & Head and Neck Surgery
Above answer was peer-reviewed by
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