Obstruction of the eustachian tube and/or posterior nostril by hypertrophic proliferative glands often causes recurrent acute, chronic or secretory (plasmacytic) otitis media (middle ear effusion); obstruction of the posterior nostril can cause open-mouth breathing, obstructive sleep apnea, occlusive nasal sounds and purulent discharge from the nostrils. Chronic paranasal sinusitis, clinically common chronic proliferative adenitis. So, how to diagnose and identify the enlarged proliferative glands physiological or pathological enlargement? The following is an introduction to the diagnosis of enlarged proliferative glands: Only in children before puberty does the disease of enlarged proliferative glands occur, which is an enlargement above the tonsils and near the back of the pharynx. Proliferative glands have a role in assisting the body’s defense system to fight respiratory infections and only cause disease when they become overly enlarged. Under normal circumstances, the proliferative glands begin to enlarge at the age of three, when children are most susceptible to infection, and they may begin to enlarge at this time to give more protection to the child’s lungs and chest. By the time the child reaches the age of five, the proliferative glands begin to shrink, and by the time puberty sets in, they have completely disappeared. In rare cases, however, they continue to grow large and eventually block the airway from the nose to the pharynx, the opening of the trachea from the middle ear to the nose, or both. If your child has repeated nasal congestion, ear pain, or an irritating cough at night, you go to the doctor, who may examine the child’s proliferative glands. The doctor will place a speculum at the back of the throat and use reflected light to check the proliferative glands. Infections caused by abnormal enlargement of the gland may be treated with antibiotics if necessary. Usually doctors do not surgically remove the gland because it will shrink and disappear by the time the child reaches puberty. However, in cases of recurring ear pain that interferes with a child’s schooling, or if the ear pain persists despite treatment with antibiotics, your doctor may recommend a glandular excision to treat the disease. This procedure is not complicated and poses minimal risk.