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Is it necessary to operate my son for adenoids?

Q: I took my 3-year-old son to an ENT surgeon for his running nose. The doctor checked his nose, throat and ears and found that he has adenoids behind his eardrum. The x-ray report says that hypertrophied soft tissue of the adenoid is seen with mild obliteration on the nasopharyngeal air column. The doctor says he needs an operation. The surgery will be done inside the ear and the adenoid will be removed or sucked from throat. He also did a hearing test and said that his right ear is already damaged and left is partially damaged. But none of us in the family noticed any problem in my son's hearing. He listens to music and watches TV as usual. Is operation necessary or can be cured by medicines? Can the operation be delayed for sometime? Is this condition common in children?

A:From the details given it seems the doctor suspects your child to be suffering from Otitis Media with Effusion (OME) with adenoid enlargement. OME can happen in children having enlarged adenoids or recurrent cold. In this there is collection of fluid behind the drum. Child may not complain of any problem or may have problem in hearing or discomfort or pain in the ear. Conservative treatment in the form of antibiotics, decongestants is given. If problem persists beyond 3 months despite treatment surgery in the form of ventilation tube in the ear is advised. Clinical appearance of the drum, hearing test and impedance audiometry help in assessing the degree of problem. In enlarged adenoids if child has recurrent OME, nasal blockage and mouth breathing then removal of adenoids is indicated.

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