A 5-year-old child has had eight episodes of acute otitis media in 6 months and has difficulty resolving the effusions between infections. What should be done to effectively eliminate the infections?

Adenoid hyperophy: MC in children Adenoids cause tubal dysfunction by mechanical obstruction of the tubal opening Serous otitis media Long standing collection of serous or mucoid fluid in the middle ear. Causes: Adenoid hyperophy or tumor No pain but hearing loss present (CHL) On examination: - Fluid filled middle ear - Thin bulging TM Management: Medical : decongestant , antihistamines , antibiotics Surgical : -Treatment of causative factor- Adenoidectomy, tonsillectomy and/or wash out of the maxillary antra maybe required. - Myringotomy & drainage of the fluid - Grommet tube inseion in the anteroinferior quadrant.