ObjectSkull base tumors in children are rare but require complex approaches with potential morbidity to the developing craniofacial skeleton, in addition to tumor-related morbidity. Reports of long-term clinical and functional outcome following skull base approaches in children are scarce. The authors report long-term outcome in children with tumors undergoing multidisciplinary skull base surgery.MethodsA retrospective analysis was undertaken of children undergoing surgery at a single institution between 1998 and 2008 for benign and malignant lesions of the anterior, middle, or posterior cranial base. Patients with craniopharyngioma, pituitary tumors, and optic glioma were excluded. Histology, surgical morbidity, length of hospital stay, progression-free survival, and adjuvant therapy were recorded. Functional and cognitive outcome was assessed prospectively using the Late Effects Severity Score (LESS).ResultsTwenty-three children ranging in age from 13 months to 15 years underwent skull base approaches for resection of tumors during the study period. The median follow-up duration was 60 months. Tumor types included meningioma, schwannoma, rhabdomyosarcoma, neuroblastoma, angiofibroma, and chordoma. Complete resection was achieved in 12 patients (52%). Thirteen patients (57%) had benign histology. The median hospital stay was 7 days. There were 3 deaths, 1 perioperative and 2 from tumor progression. Two patients had CSF leakage (9%) and 2 developed meningitis. Two children (9%) had residual neurological deficit at last follow-up evaluation. Thirteen (59%) of 22 surviving patients received adjuvant therapy. The majority of the patients remain in mainstream education and 19 of the 20 surviving children have an LESS of 3 or lower.ConclusionsChildren tolerate complex skull base procedures well, with minimal surgical-related morbidity as well as good long-term tumor control rates and functional outcomes from maximal safe resection combined with adjuvant treatment when required.
This work presents a novel technique for designing chipless radio frequency identification (RFID) tags which, unlike the traditional tags with complex geometries, are both compact and printable. The tags themselves are alphabets, which offers the advantage of efficient visual recognition of the transmitted data in real-time via radio frequency (RF) waves. In this study, the alphabets (e.g., a, b and c) are realized by using copper etching on a thin dielectric substrate (TLX-8) backed by a ground plane. It is shown that the original signature of the frequency response of the backscattered radar cross-section (RCS) of the letter, displays dips that are unique to the individual letters. The tags have been simulated, fabricated and their monostatic cross-sections have been measured by using a dual-polarized Vivaldi antenna in the frequency band ranging from 6 to 13 GHz. The study also includes, for the first time, a detailed analysis of the impact of changing the shape of the tag owing to variation in the font type, size, spacing, and orientation. The proposed letters of the alphabet are easily printable on the tag and provide an efficient way to visually recognized them and, hence, to detect them in a robust way, even with a low coding density of 2.63 bit/cm2. The advantages of the proposed novel identification method, i.e., utilization of the both co- and cross-polar RCS characteristics for the printable clipless RFID tags are the enhancement of the coding density, security and better detection of the alphabet tags with different fonts by capturing the tag characteristics with better signal to noise ratio (SNR). Good agreement has been achieved between the measured and simulated results for both co- and cross-polarized cases.
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