Sharnis N., 7

Sharnis is a 7-year-old girl who is kind, humble, and bright, with a strong love for reading and singing—qualities that reflect great academic and personal potential. She lives with her parents in a rural village where resources are limited. Her father is the sole provider, earning a modest income from selling fruits and vegetables, which is often insufficient to meet the family’s basic needs, including food, school supplies, and healthcare. Despite these challenges, Sharnis remains enthusiastic about learning and continues to perform well, showing promise if given adequate support. She was brought to the emergency unit with a one-week history of difficulty in breathing and episodes of paused breathing. Her grandmother reported long-standing mouth breathing, loud snoring, and witnessed apnea during sleep. She also had recurrent nasal congestion, hyponasal speech, occasional difficulty swallowing, restless sleep, daytime fatigue, and poor concentration in school. On examination, she appeared stable but was mouth breathing at rest. Enlarged tonsils (grade 3+) and reduced nasal airflow were noted. A lateral neck X-ray confirmed enlarged adenoids causing airway narrowing, leading to a diagnosis of symptomatic adenoidal hypertrophy with tonsillar enlargement.

Sharnis was brought to our emergency unit with history of difficulty in breathing and moments of pause in breathing over the past week . Her grandmother reported chronic mouth breathing, loud snoring during sleep, and episodes of witnessed apnea at night. She also had recurrent nasal congestion, hyponasal speech, and occasional difficulty swallowing. There was a history of restless sleep associated with daytime fatigue and poor concentration in school. No history of recurrent epistaxis or significant weight loss was noted.

Sharnis presents with significant symptoms of upper airway obstruction due to enlarged adenoids and tonsils, including difficulty in breathing, snoring, and sleep disturbances affecting her daily functioning and school performance. Surgical intervention (adenoidectomy with or without tonsillectomy) has been recommended to relieve the airway obstruction. She is currently stable and fit for surgery. The prognosis is very good, as most children experience marked improvement in breathing, sleep quality, and overall well-being after the procedure. With proper post-operative care and follow-up, she is expected to recover well and resume normal activities with improved quality of life.