grd 4 adenoids are best removed. But ofcourse depends upon other factors. For detailed history and examination visit an ent surgeon. Postponing for few months is ok ..but for years... it's definitely going to do some irreversible damage...let it be as small as 5-10%.

Incase of Grade IV adenoids, you need to look for other factors such as if the child has any facial changes due to adenoid enlargement called adenoid facies. Also need to get her ears checked to see if there is any fluid accumulation called serous ottitis media (SOM). Also better to get an audiometry test done for the same. If Adenoid facies and SOM present, then delaying the surgery further is not advisable as the damage due to these are not reversible. If the above not present and you still insist on delaying the surgery, then can use momeflo nasal spray and be on regular follow up with ENT for the same.

Postponing grade 4 adenoid surgery is not a good idea Problem will worsen day by day also cause difficulty in breathing better to plan for surgery if she is fit for age and surgery

Mam start her on metatop nasal spray 2 puff twice a day for 2 month and then please follow up

Ideal to do surgery after 5years age, start on nasal spray and immunomodulator syrup; dosing after ent doctor consultation.

Metaspray nasal spray 2 puffs two times a day for 8 weeks.

We can postpone the surgery for another 2-3 yrs , but it depends on the child's condition( severity) Use the steroid nasal spray Better to consult nearby  ENT doctor