This case involves a child who was diagnosed with sickle cell disease and asthma during his first year of life,¹ and was frequently hospitalized for ear infections, upper respiratory infections, and sickle cell pain crisis. At age one, the child’s pediatrician referred him to an ENT clinic for an evaluation of his symptoms. Dr. B, an ENT surgeon, reviewed the medical records and performed a physical examination. He recommended the patient undergo a Bilateral Myringotomy Tympanostomy and Tubes (BMT) and adenoidectomy to eliminate the recurring ear infections and reported mouth breathing.