What non-surgical management options are available for children with mild adenoid hypertrophy and associated symptoms?

For children with mild adenoid hypertrophy and associated symptoms, non-surgical management options primarily focus on supportive care and symptom management rather than pharmacological or invasive treatments.

These options include:

• Advice and education for parents and carers about the condition, including how to support the child in daily activities and educational settings, such as minimizing background noise, facing the child when speaking, and informing teachers to make appropriate adjustments.
• Avoidance of tobacco smoke exposure as it may increase the risk of worsening symptoms.
• Monitoring and watchful waiting with regular review, as mild cases often do not require active intervention and may improve over time.

Pharmacological treatments such as oral or nasal corticosteroids, antihistamines, leukotriene receptor antagonists, mucolytics, proton pump inhibitors, anti-reflux medications, and decongestants are not recommended for managing symptoms related to adenoid hypertrophy or associated otitis media with effusion (OME).

Non-surgical interventions like homeopathy, cranial osteopathy, acupuncture, dietary modifications including probiotics, and massage are also not advised.

When symptoms are related to OME or hearing loss, options such as auto-inflation may be considered if the child can engage with the treatment, but antibiotics should not be offered.

Overall, the emphasis is on supportive care, avoidance of risk factors, and careful monitoring rather than active medical or surgical treatment in mild cases.

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