It is important to know the size of adenoids
in X ray
Ideally X ray for adenoids has to be done when there is no acute infection, to see the real size of Adenoids.
If the adenoids are very big blocking nasopharynx
(upper part of throat behind nose) almost completely, then better go for surgery as no medicine is likely to help. There is no need to be scarred about it. It is a minor surgery done as a day case.
If left like that he may develop or already having sleep apnoea with resultant heart problems, reduced oxygenation to developing brain etc.
If there is at least 2 to 3 millimetres of space between adenoid and nasopharynx,then X ray sinuses
can be taken. If infection is found there it has to be treated. If sinuses have no infection, a course of antibiotic, nasal decongestants with nasal steroids
can be tried. If there is improvement maintenance is with long term antihistamine and nasal steroids. Normally adenoids regress by the age of 10 to 11 years. So after that he will not need these medications.