What is the treatment of choice in a 6 year old child with recurrent UI with mouth breathing having high arched palate, impaired hearing and growth failure?
Hyperophic adenoid tissue causes nasal obstruction, mouth-breathing, and similarly, obstruction of the Eustachian tube orifices. Removing large adenoids enhances the patency of the nasopharyngeal airway, relieving the overall pressure in the nasopharynx, in turn allowing improved aeration of the middle ear cleft. The goal of placement of tympanostomy tubes is to aerate the middle ear space and prevent accumulation of middle ear inflammation and effusion. In effect, ventilation of the middle ear enhances hearing thresholds.
Tonsillectomy
Grommet inseion
Myringotomy with grommet inseion
Adenoidectomy with grommet inseion