A 5-year-old male child presented with a history of recurrent sore throat, fever, mouth breathing for the past 3 years. The parents also give history of sleep-disordered breathing including witnessed apneic episodes. History of nocturnal enuresis also present.
On examination
- Adenoid facies present.
- Mouth breathing present.
- Oral cavity: Crowded tooth
- Oropharynx: Grade III tonsils
- Anterior rhinoscopy: normal
- Posterior rhinoscopy: Adenoid hypertrophy present.
- Ear: Bilateral tympanic membrane appears dull and bulged.
- Neck: Bilateral jugulodigastric nodes present and tender.
Investigations done.
- Xray nasopharynx: GIII Adenoid hypertrophy.
- Diagnostic nasal endoscopy: Please see the image above.
- Routine blood: Hemoglobin, Platelets, aPTT, PTINR were normal.
- Pure tone audiometry: Bilateral mild conductive hearing loss
- Tympanometry: Bilateral B curve.
Questions
- What is your diagnosis?