Adenoid hypertrophy in children has been a popular and sensitive term in recent years, and is one of the most performed procedures in pediatric ENT. Combined with some of the children who have come to us over the years and the follow-up after surgery over the last 8 years. In fact, this is a very wrong viewpoint. Among children aged 2-7 years old, if they have a nasopharyngeal examination, about 85% of them have different degrees of adenoidal hypertrophy, which is a normal physiological phenomenon. This is a normal physiological phenomenon, and only a part of them will lead to clinical symptoms, and a very small part of them need surgery. 2. Children with recurrent fever, cough, phlegm and frequent respiratory infections are found to have adenoidal hypertrophy at this time, so they think that all symptoms will disappear completely and will not appear again after adenoids surgery. If you go for the surgery with such a purpose, your satisfaction after the surgery will definitely not be high because adenoid hypertrophy is not directly related to recurrent respiratory infections and chronic cough. 3, the child’s nasal congestion and snoring are caused by allergic rhinitis and sinusitis, adenoidal hypertrophy is only part of the factor, and the surgery only removes one adenoid, while allergic rhinitis and sinusitis cannot be treated by surgery, but need long-term and repeated insistence on medication, and the effect of surgery for children with allergic rhinitis is worse than that for children without allergic rhinitis, and some of these children, after medication If the nasal congestion and snoring improve or even disappear completely, these children do not need surgery at all. If your child’s tonsils are often septic and have high fever, more than 4-5 times a year, then during adenoid surgery the doctor recommends removing all the tonsils, first to avoid frequent and repeated inflammation affecting the heart and kidneys, and second to avoid repeated inflammation of the tonsils, which can easily become hypertrophic after surgery. If your child’s tonsils are basically not septic, inflamed, or occasionally 1-2 times, then there can be different treatments depending on the size of the tonsils. This is because the low temperature plasma radiofrequency ablation technology now allows us to update and improve our procedures in ways that were simply not possible before. For 3rd degree hypertrophic tonsils, all of them can be ablated or most of them can be ablated, but it is not recommended to leave them untreated. This is because every year we have children who have to have a second surgery because they did not have their tonsils treated during the last surgery and now have abnormally enlarged and hypertrophied tonsils. There are also different treatments for 2nd degree hypertrophy of the tonsils depending on the size. The treatment of large 2nd degree, near 3rd degree hypertrophy tonsils is the same as that of 3rd degree hypertrophy tonsils. Tonsils with small 2nd degree hypertrophy can be partially ablated or decompression surgery can be performed. The results of volume reduction are particularly good for small 2-degree hypertrophy tonsils, and basically no re-growth of hypertrophy of tonsil tissues was found in the 1-year follow-up after the surgery. However, for large 2nd and 3rd degree tonsils, the results are not particularly good because there is a certain limit to the volume reduction. In the past, the tonsils of degree 1 were not treated. Now, with the increasing number of children operated on and the increasing number of follow-up visits, we have found that the tonsils that were 1 degree at the time of surgery have become enlarged and hypertrophied to varying degrees after surgery, and some have begun to affect the child’s breathing and sleep. Therefore, at present, we generally recommend that tonsils of 1st degree size also undergo volume reduction surgery, which can make the tonsil tissue appear scar tissue hyperplasia to avoid abnormal hyperplasia and hypertrophy in the future (especially for younger children). 5, some hospital doctors require immediate surgery, while some doctors say that surgery is not needed This surgery is done or not. In fact, the need for surgery after adenoid hypertrophy, snoring, open-mouth breathing and apnea is not a personal conjecture of the doctor, but an objective scientific basis exists. A comprehensive evaluation report will be given, and based on the data in the report, a decision will be made whether to operate or to treat conservatively with medication. It is worth noting that the test cannot be performed when you have a cold or fever, which will affect the accuracy of the test results, and that rhinitis and sinusitis can only be examined after they are basically under control. In conclusion, it is very important to repeatedly and carefully inquire about the medical history during the outpatient consultation, to understand the past treatment and the effect of the treatment, and to communicate in detail with the parents of the child before deciding whether to operate or not.