The dangers of adenoids and tonsillar hypertrophy have been recognized by many parents, and active treatment is the consensus of all parents, but when faced with the choice of treatment, almost all parents think about it and have difficulty in choosing. According to the general logic, surgery is definitely more damaging and risky than medication, therefore, with the normal reaction of avoiding harm, almost all parents want to solve the problem through conservative treatment and refuse surgery. So, is this right? Actually, this idea is not entirely right or wrong, but depends on the severity of the disease. Let’s analyze the pros and cons of surgery versus medication. First of all, let’s talk about the problems associated with surgical treatment. Parents’ concerns are summarized in two areas: first, they are worried about the damage and trauma of surgery, especially whether general anesthesia will affect the child’s intellectual development. The second concern is that the adenoid tonsils will affect the immune function after removal. So, what is the actual situation? There is no doubt that there is damage in surgery, and any surgical operation will have certain risks, but with the improvement of surgical instruments and methods, the trauma has been very small, and the risk of surgery is also relatively small, the biggest risk is the post-operative bleeding, the incidence of which is about 0.1%-1%, usually relatively small bleeding through the use of local cold compresses, vasoconstrictive drugs can be very good control, will not However, once the bleeding is large, there is a risk of suffocation caused by backflow into the trachea, which usually requires a second trip to the operating room to stop the bleeding, and the risk is relatively high. In terms of overall incidence, major postoperative bleeding is very rare and has not been encountered in the author’s career of more than 10 years so far, and is rarely reported in the relevant literature. Therefore, in general, the safety of the operation is still guaranteed. As to whether general anesthesia affects the child’s intellectual development, there is almost no effect from the current study results, especially in children after the age of 3. There is no difference between children who receive general anesthesia and those who do not receive general anesthesia in terms of intellectual level, logical thinking ability and behavior. Finally, a word about whether immunity will be affected, adenoids and tonsils are important immune organs of the human body, especially in childhood, both play an important role, but the function of the two is not irreplaceable, because there are many lymphoid tissues with the same function under the mucosa around them, which can completely replace their functions, in addition, the human immune system is a complex system In addition, the human immune system is a complex system with a strong reserve capacity, and the adenoid tonsils are only a very small role in this system, which can be completely compensated by other means. From the data of the relevant studies, after adenoid tonsil removal, the relevant immune indicators will slightly decrease (but still within the normal range), and in about 1 month, the indicators will return to the preoperative level. For individual children with recurrent tonsillar adenoid inflammation, the immune indicators will be significantly better after surgery than before, so instead of being prone to colds, they will be less prone to colds, rhinitis, and pharyngitis. Again, medication is preferred for children with acute onset of the disease. If the treatment is timely and appropriate, it is usually easy to control the symptoms. For children with mild symptoms, we also advocate the first choice of medication, which mainly includes nasal spray medication (mainly nasal spray hormone) and medication to promote the discharge of secretions. The relevant research data shows that with standardized medication (nasal spray hormone for 1-2 months), patients with mild symptoms can usually obtain good results and can be maintained for a longer period of time. In this era of “hormone talk”, many parents are willing to choose non-hormone treatment, especially herbal treatment. In fact, this is a misconception. Firstly, the safety of nasal spray hormone has been confirmed by several studies, and secondly, there is evidence that the effective treatment is nasal spray hormone. So, in what cases should medication alone not be considered? In cases where the history is long (more than 3 months), the symptoms are severe (severe whistling or even apnea, etc.), and medication is not effective, surgical treatment should be sought in a timely manner. The reason for this is that long-term recurrent inflammation can cause the production of a large number of inflammatory factors, which may be far more damaging to the body than the benefits of the presence of adenoid tonsils, in addition to the long-term use of a large number of drugs can cause chronic damage to the liver and kidneys and other organs, which may be far more harmful than the impact of a general anesthetic on the child. Therefore, the current view is that surgery is the first line of treatment for children with more severe disease. Finally, regarding the timing of surgery, the traditional view is that adenotonsillectomy may be performed after the age of 4. This view has now been rejected by the academic community. The current view is that there is no absolute age limit for surgery, but depends mainly on the severity of the child’s condition, and the minimum age reported for such surgery is 6 months after birth. Considering the risks of surgery and the immune function of the child, it is safer to operate after 3 years of age if the condition allows. However, it is not advisable to delay the surgery excessively, because the child is at a peak of facial development between 4 and 7 years of age, and missing this period usually results in a certain degree of abnormal facial development, which in some cases requires follow-up orthodontic treatment after surgery, increasing the difficulty and time cost of treatment.