Jenipher B., 7

Jennifer is a seven-year-old girl in grade one at her local public primary school. She currently lives with her grandmother, who is the sole provider for the household, while her mother is away trying to do casual jobs to support the family. Jennifer is an active child who loves dancing with other children at church, and she dreams of becoming a nurse one day. Her favorite foods are fish and ugali. Since birth, Jennifer has experienced persistent snoring accompanied by mouth breathing, episodes of sleep apnea, restless nights, bad breath, and frequent refusal to feed. She has also had recurring fevers and repeated episodes of tonsillitis. Because of the narrowing in her nasopharyngeal airway, her speech is affected, making communication difficult. During oral examination, she was found to have a tongue tie and grade 4 enlarged tonsils, which, although not inflamed at the time, significantly reduce her nasopharyngeal airway space. Based on these findings, the recommended treatment plan includes an adenotonsillectomy and release of the tongue tie to improve her breathing, feeding, sleep quality, and speech development.

The patient was reviewed by an ENT specialist on 02/12/2025 and was confirmed to have Grade IV tonsillar enlargement and a tongue tie. The patient had a long-standing history of snoring, mouth breathing, sleep apnea, and recurrent throat infections. Following the assessment, an adenotonsillectomy and tongue-tie release were performed. The patient remained stable after surgery and showed marked improvement in breathing. She was discharged on 04/12/2025 in good condition and placed on appropriate discharge medications.

Jennifer’s overall prognosis after adenotonsillectomy ought to be very good, especially given the severity of her symptoms before surgery. Removing the enlarged tonsils and adenoids is expected to relieve the obstruction in her upper airway and significantly improve her quality of life.