Adenoid Hypertrophy

A 6-year-old boy from Delhi presents with a 3-month history of persistent nasal obstruction and mouth breathing. His mother reports he snores loudly at night and has had 4 episodes of acute otitis media in the past 6 months. On examination, he has a long narrow face, high-arched palate, and dental malocclusion. Intraoral examination reveals enlarged, pale, lymphoid tissue in the nasopharynx obstructing the choanae. Otoscopy shows dull tympanic membranes bilaterally. What is the most likely diagnosis and the primary mechanism of recurrent otitis media in this child?

An 8-year-old girl from Mumbai presents with a 4-month history of progressive nasal obstruction, chronic cough, and failure to thrive (weight < 3rd percentile). Her parents report she has had 6 upper respiratory tract infections in the past year and complains of ear fullness. On examination, she has hypernasal speech, a high-arched palate, and dental crowding. Flexible nasopharyngoscopy reveals large, pale, lymphoid tissue completely obstructing the nasopharynx and impinging on the soft palate. Tympanometry shows Type B curves bilaterally. Which of the following is the most appropriate next step in management?