Management of a 6-year-old child with recurrent URTI with mouth breathing and failure to thrive with high arched palate and impaired hearing is:

(d) Adenoidectomy with grommet insertion(Ref. Scott Brown, Vol 2; 288)Recurrent URTI with mouth breathing and failure to thrive in the given 6-year-old child with high arched palate is due to persistently hypertrophied adenoids.The impaired hearing is due to serous otitis media which in turn is because of hypertrophied adenoids blocking the Eustachian tubes.So treatment will be adenoidectomy with grommet insertion.