A 6-year-old child presented with history of recurrent upper respiratory tract infections, mouth breathing, nasal obstruction and hearing impairment. Management will be:

Symptoms of nasal obstruction, mouth breathing and hearing impairment are due to adenoids, and adenoidectomy would be required. Since the child also suffers from hearing impairment (due to otitis media with effusion), a myringotomy with grommet insertion will be required. Simply doing myringotomy (optimised) will lead to recurrence unless cause (adenoids) is removed.