This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Anatomy
6 year old child with recurrent UI with mouth breathing and failure to grow with high arched palate and impaired hearing has to undergo: 
Select and explain. 
A. Tonsillectomy, B. Grommet inseion, C. Myringotomy with grommet inseion, D. Adenoidectomy with grommet inseion
D: Adenoidectomy with grommet inseion
Answer: D: Adenoidectomy with grommet inseion 
Explanation: The child is gaving recurrent UI with high arched palate and failure to grow which indicates child is having adenoids and since there is impaired hearing it means child has developed otitis media as a complication. Hence logically the child should be treated with adenoidectomy with grommet inseion.This is fuher suppoed by following lines from Scott Brown. "Current practice is to perform adenoidectomy as an adjunct to the inseion of ventilation tubes." Ref Scott Brown 7/e,Vol 1,p 902.