This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Operative Surgery, Subject name: ENT
6 year old child with recurrent URTI with mouth breathing and failure to grow with high marked palate and impaired hearing is : 
Select and explain. 
A. Tonsillectomy, B. Grommet insertion, C. Myringotomy with grommet insertion, D. Adenoidectomy with grommet insertion
D: Adenoidectomy with grommet insertion
Answer: D: Adenoidectomy with grommet insertion 
Explanation: Ans. is 'd' i.e. Adenoidectomy with grommet insertion insertion Hearing impairment and the option of myringotomy and grommet insertion suggests that the patient is also suffering from Serous otitis media (glue ear/secreting otitis media) which is one of the complication of adenoid hyperplasia. Treatment of glue ear requires myringotomy and grommet insertion.