The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
The rate of revision rhinoplasty as well as the duration of follow-up were recorded in this group of patients. Five (8%) of 62 patients underwent revision surgery. This rate of revision is similar to that of all patients undergoing rhinoplasty with the senior author (3%-8%). The reasons for revision surgery varied in this small group of patients: synechine in 2 patients, a residual twisted nose in 1 patient, an overprotected dorsum in 1 patient, and implant reaction in the final patient. In all cases, revisions were performed for reasons other than dissatisfaction with the result of the caudal septum. Most of these patients had deformities in addition to caudal septal deviation, and all underwent procedures in addition to caudal septoplasty for treatment of these deformities.