Endoscopic adenoidectomy in a 13-month-old child with failure to thrive: a case report

Abstract

Adenoid hypertrophy is a common cause of upper airway obstruction in infants and toddlers. When severe, it can cause significant symptoms such as nasal obstruction, feeding difficulties, failure to thrive and sleep disturbances. Timely surgical intervention is crucial for symptom resolution and optimal growth. A 13-month-old male presented with breathing difficulty, mouth breathing, snoring and difficulty in feeding. Clinical examination revealed suprasternal and intercostal retractions. A lateral nasopharyngeal radiograph showed significant adenoid hypertrophy, which was confirmed as Grade 4 on nasal endoscopy. The child underwent endoscopic adenoidectomy under general anesthesia. Postoperatively, there was marked improvement in respiratory and feeding symptoms. At three-month follow-up, the child had gained 2 kg, with no recurrence of symptoms, indicating a successful outcome. Endoscopic adenoidectomy in infants with significant adenoid hypertrophy is a safe and effective intervention. It improves airway patency, feeding  and growth and should be considered in severe symptomatic cases even at a younger age.