Patient: nasal congestion with thick runny nose. It has been three months now. Recently just had a pus nose. I just found out adenoid hypertrophy and am on antibiotic treatment. I don’t want to have surgery, can I be cured by conservative treatment? What kind of medicine should I use? Is it okay to use Nesuna drops? Zhang Xiaowen, Department of Otolaryngology, The First Affiliated Hospital of Guangzhou Medical College: Tonsil and adenoidectomy (T&A) is the most common operation in pediatric surgery. Obstructive sleep apnoea (OSA) is well established as the best indication for T&A in children, but recurrent upper respiratory infections (URIs) are controversial as an indication for T&A: first, there is a lack of sufficient randomized studies. The second is the lack of significant improvement in symptoms of upper respiratory tract infections after T&A. Sclatan noted that children with chronic tonsillar and adenoid hypertrophy with symptoms of respiratory obstruction required significantly less surgery after 30 days of amoxicillin-potassium clavulanate treatment. In recent years, foreign scholars have reported that systemic and topical adrenocorticotropic hormones have a role in reducing and treating OSA in children. Based on the detection of hormone receptor subtype expression in adenoiditis and adenoid hypertrophy tissues and theoretical confirmation that glucocorticoids should have therapeutic effects on both adenoid hypertrophy and adenoiditis, we applied mometasone furoate nasal spray (Nesuna) for the treatment of tonsillar and adenoid hypertrophy in children and achieved certain efficacy. My experience: amoxicillin-clavulanate potassium or macrolide antibiotics + nasal adrenocorticotropic hormone treatment for 1 month, the symptoms of respiratory obstruction, cough, runny nose, etc. do not improve significantly, accompanied by hyperactivity, sleep dreamy awakening, grinding teeth, bedwetting, slow reflection, inattention and irritability and other manifestations affecting development, learning, life, etc. can be considered surgery. Adequate preparation before surgery, surgical risks and removal of tonsils and adenoids have little impact on the child.