A 6-yr-old child presents with recurrent URTI with mouth breathing and failure to grow with high arched palate and impaired hearing. His tympanogram finding is given below. He should be managed by:

(d) Adenoidectomy with grommet insertion(Ref. Scott Brown, 8th ed., Vol 2; 125)This child is suffering from adenotonsillar hypertrophy which is causing recurrent URTI, mouth breathing, failure to grow and high-arched palateHypertrophied adenoids may have led to Eustachian tube blockade with a resultant SOM which explains impaired hearing.So the treatment is adenoidectomy with grommet insertion. It is understood that the grommet has to be put by radial Myringotomy in the antero-inferior quadrant.