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Probable Asthmatic
June 2001

Q. I have an 8-year-old son whom has had breathing problems since he was an infant. At about 7 months of age he was diagnosed as a high probability of being asthmatic and was treated as such. He remained on the treatment up until about a year and a half ago when he seemed to be doing better and has not had an attack since age 6. However, he continued to breath thru his mouth and ate very little but often and snored loudly constantly...

Last year he was diagnosed as having enlarged tonsils and was scheduled to have them removed, I questioned his adenoids at the time and was told they would be removed as well. However after the surgery the doctor told me that he did not remove the adenoid as they appeared to be fine. Now, just over a year later the same doctor is telling me that he has enlarged adenoids. Also, the doctor has prescribed Nasonex twice a day, two sprays in each nostril. He says that if this does not work he would like to schedule surgery to remove the adenoids. Do adenoids generally grow like this? I understood that generally children with enlarged adenoids sort of grow into them. Should I allow him to have another surgery, or should I make every effort to stay away from it?

A. A few decades ago tonsillectomy (along with removal of the adenoids) was an incredibly common procedure. Since that time, the procedure has become a lot less common, primarily because we have learned that most children end up not needing the procedure after they reach about age seven. The procedure is now relegated to those who have severe problems at a younger age or persistent problems at a later age. Whether or not your son required an adenoidectomy along with removal of the tonsils is impossible to tell, but I think we should trust the surgeon who did the procedure. Whether your son needs the procedure now is to a degree a matter of opinion. If he has a horrible time sleeping, is sleepy throughout the day, or is having medical problems caused by the forced mouth breathing, then the adenoidectomy is probably a good idea. If your son is tolerating the large adenoids well, then waiting might be an acceptable option since with time his nasal passages will grow in size and the adenoids will tend to shrink, making the surgery less necessary.

The final determination has to be made by the doctor examining him and yourself. You can learn more about tonsils and adenoids on the following Web pages:



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