Hello and most welcome to HCM, I appreciate your concern regarding your child s problem. Just before answering your question i would like to say that, the way you put the question was very accurate and you have very nicely presented the history. O.K i will directly go to answer your question first and then i will go for explanation. Your concern was - I don t want my son to go for surgery at all and also want him to be completely cured of this problem. Please help My answer: Go for a nasal spray with combination of antihistamine and steroid Ya..that was a straight line. I know that moment you have read the above line, lot of questions might have coming to your mind. Please let me help you with few explanations. It has been seen that with a course of steroid nasal spray (not oral steroid), adenoid greatly reduces in size and also there is a great clinical improvement. Antihistaminic adds to its improvement. I prefer this combination but some Doctors prefer the steroid spray alone. I myself has got many patients who have improved a lot by this method. Here, i can t write this prescription as it is NOT allowed by HCM. At this point, please let me again concentrate on one more line you have written, and that is-- adenoids enlarged in the nasopharynx region,indenting the air column .. Now, that is the point of concern. In any case where there is compromise of airway, we definitely have to consider surgery/adenoidectomy as priority. That may be the first reason why your Doctor has advised surgery. Laser adenoidectomy is very safe, effective and a very advanced method of treating enlarged adenoid. You might got puzzled by this time knowing both the option and might be thinking what to do and which treatment to accept. You might be expecting me to answer that question, and my answer is - BOTH options can be tried. O.K........O.K......Please do not get annoyed, i will try to answer you in a different way. If a child with similar condition comes to me, i evaluate if the child has previous history of any Chicken pox/TB or any present viral/fungal infection or airway obstruction etc.. is present. If no such history, than i prefer medical treatment (i.e., the nasal spray) first. From my experience, maximum of my patients got relieved and waived off from surgery. The rest of the patients definitely needed surgery. So, with these explanations, i definitely mean that steroid spray is still an option left in your hand if you really do not want your child to undergo surgery and want him to get more or less equally cured at the same time. Finally in summary (absolutely from my personal opinion) - 1st - Steroid Nasal Spray 2nd - Adenoidectomy if needed. Anyway, seeing is always better than assuming, so your local doctor s decision must be taken with respect as he has clinically examined your child and he will be the best to judge the present condition of your child and the best treatment for him. With this i have made a very sincere approach to help you out with your question and i humbly believe that i could ease your mental turmoil at least some, if not all. I wish your child a very very early recovery and a very Happy life ahead. Thanks