Parents often ask whether they need surgery for adenoidal hypertrophy in other hospitals, regardless of their age and other conditions, in their usual clinical work or online. When a child is found to have adenoid hypertrophy, he or she should be asked in detail about the child’s sleep, his or her usual breathing, the presence of rhinitis, nasal deformities, the presence of a high palatal arch in the mouth, a small lower jaw, and a dropped tongue, and asked in detail about previous treatment and results. If the child has frequent nasal congestion, open mouth breathing, open mouth breathing during sleep, nasal congestion, sometimes breath-holding and waking phenomenon, after excluding rhinitis, nasal malformation, high palatal arch, small jaw, posterior fall of the tongue, and only simple adenoid hypertrophy caused by these conditions, then it should be operated as soon as possible, if the child is found to have rhinitis, allergic diseases, then the regular course of treatment should be observed after the efficacy, such as through treatment If the symptoms do not improve after treatment, or if the child has to rely on nasal mucosa contraction drugs and will relapse once the drugs are stopped, then surgery is still needed. If the symptoms recur for more than two years, surgery is needed as soon as possible. In our long-term clinical treatment, we found that the best age for pediatric adenoid hypertrophy surgery is 3-6 years old, 6 years old and above because they are already school-age children, if they sleep poorly at night, it will affect the daytime classes, learning, resulting in poor concentration and memory loss. Children under the age of 3 years old have a narrow nasal cavity and a small nasopharyngeal cavity, and the nasal mucosa is easily swollen, so the improvement of symptoms after surgery is not as obvious as in older children. However, if a child under 3 years of age is excluded from rhinitis, or if he or she still has significant breath-holding, wakefulness, poor sleep, feeding difficulties, and failure to grow after a period of medication, early surgery is warranted, otherwise the constant state of hypoxia will increase the burden on the child’s heart and affect growth and development. As for the way of surgery, initially, the adenoids were scraped blindly with the doctor’s experience, which easily caused the residual adenoid tissue in the nostril area after the surgery, and it was easy to increase the hypertrophy again. Later on, it was developed to use adenoidal suction knife under the endoscope to stir up the tissue and remove it at the same time. The surgical field of vision is clear, but the disadvantage is that there is more bleeding and some small parts of adenoidal tissue are easily overlooked when bleeding and remain, and the postoperative hemostasis is done by electric coagulation, which is more damaging to the surrounding tissues. Recently, the real minimally invasive surgery is low-temperature plasma radiofrequency ablation, which uses plasma to vaporize and eliminate adenoid tissues, with almost no bleeding on the trauma, clear surgical field, and is low-temperature with little damage to the surrounding tissues and fast recovery. The problem of recurrence after the surgery is also a concern for parents and more inquiries. Adenoid tissue is essentially lymphatic tissue, not tumor tissue, and will not grow back as long as it is completely removed during surgery. However, after the surgery, it is found that some children have been snoring, and some have been breathing with open mouth and holding their breath, which may be related to the following reasons: a. Some children have greater resistance in the upper respiratory tract, and may have been snoring during sleep, but only without holding their breath and lack of oxygen, which will not affect the growth and development of the child. Second, there is a cold or rhinitis attack, and the symptoms will appear again when the nasal mucosa is swollen, but this situation can be relieved only by medication. The swelling of the nasopharyngeal bulge is obvious, and underneath the bulge is the eustachian tube, which is a very important structure for maintaining the pressure balance in the ear and should not be damaged, but children with allergies or very young children have a high percentage of bulge swelling after surgery, so it is necessary to recognize and consider this problem during surgery. Finally, we will talk about anesthesia for surgery. Pediatric anesthesia is not a replica of adult anesthesia, and it is fundamentally different from adult anesthesia. We are very careful in the selection of drugs, drug dosage and anesthesia equipment. We strive to minimize the damage and impact on the child. The surgeon’s skill accounts for 50% of a successful surgery, and the other 50% is due to the perfect cooperation of the anesthesiologist, so it is crucial to choose a hospital specializing in children and an experienced pediatric anesthesiologist.