Objective To explore the numerical simulation of the airflow field in children with adenoid hypertrophy after surgery, and analyze the risk factors for postoperative recurrence.

Methods The clinical data of 110 children with adenoid hypertrophy were retrospectively analyzed, and included in the training set. Thirty children with adenoid hypertrophy who were treated in our hospital during the same period were selected as the validation set. According to the postoperative recurrence situation, the children in the training set were divided into the recurrence group (22 cases) and non-recurrence group (88 cases). The clinical data, preoperative and postoperative CT scans and numerical simulation results, as well as other clinical data between the training set and validation set were compared. Multivariate logistic regression was used to analyze the influencing factors of recurrence after surgery. A nomogram model was constructed, and the model's performance was evaluated.

Results The differences of the nasopharyngeal cavity volume, overall pressure and airflow velocity distribution in the training set were statistically significant between before and after operation (P ＜ 0.05 ~ P ＜ 0.01). Compared with the operation, the low-density shadow of the hypertrophic adenoid disappeared after operation, the posterior nasal aperture and nasopharyngeal airway were unobstructed, the paranasal sinus mucosa basically returned to normal, and there were no secretions in the paranasal sinus cavity and ear cavity. The pharyngeal orifice and pharyngeal recess of the eustachian tube can be clearly seen. The results of logistic multivariate regression analysis showed that the postoperative infection, incomplete adenoidectomy, rhinosintis, otitis media and tonsillitis were the risk factors of recurrence after adenoidectomy in children with adenoid hypertrophy (P ＜ 0.05 ~ P ＜ 0.01). The analysis of the receiver operating characteristic (ROC) curve and calibration curve results indicated that the nomogram prediction model had a high degree of discrimination and accuracy.

Conclusions Postoperative infections, rhinitis (sinusitis), otitis media, etc. are associated with the postoperative recurrence in children with adenoid hypertrophy. Constructing a nomogram model (which needs to specifically describe its predictive results) is conducive to the formulation of personalized diagnosis and treatment plans in clinical practice to reduce the postoperative recurrence rate.