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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Exponemos nuestra experiencia en el tratamiento de los neurinomas del ac&#250;stico con radiocirug&#237;a&#44; mediante un aparato de telecobaltoterapia &#40;Theraton 80&#41;&#44; acoplado a un sistema de esterot&#225;xia&#44; en cinco pacientes ancianos&#44; cuya edad promedio fue de 70 a&#241;os&#46; Todos ellos presentaban patolog&#237;as graves asociadas que imped&#237;an el tratamiento quir&#250;rgico&#46; El di&#225;metro promedio del tumor era de 21<span class="elsevierStyleHsp" style=""></span>mm&#46; Se administr&#243; radioterapia &#40;Radiocirug&#237;a&#41;&#44; con una dosis promedio de 2&#46;770 cGy &#40;rango 2500 a 3750 cGy&#41; en una sola sesi&#243;n&#44; mediante un promedio de 17&#44;8 campos isoc&#233;ntricos con un colimador de 20<span class="elsevierStyleHsp" style=""></span>mm&#46; de di&#225;metro&#46; La repartici&#243;n de la isodosis se hizo de la siguiente manera&#58; en los casos 2 y 4 el 90&#37; de la isodosis alcanz&#243; la periferia del tumor&#44; en el caso 5 el 80&#37;&#44; en el caso 3 el 40&#37;&#44; mientras que en el caso 1&#44; s&#243;lo el 20&#37; de la isodosis alcanz&#243; la periferia del tumor&#46; La radiaci&#243;n fue bien tolerada por todos los pacientes&#46; La TAC de control puso de manifiesto la disminuci&#243;n del tama&#241;o de la lesi&#243;n en 3 pacientes y la aparici&#243;n de una zona hipodensa central en 2&#46; Un paciente desarrollo hidrocefalia y radionecrosis de cerebelo que precis&#243; derivaci&#243;n del LCR y tratamiento con corticoides&#46; Dos pacientes tuvieron una buena recuperaci&#243;n&#44; otro ten&#237;a una moderada incapacidad y 2 se han estabilizado&#44; pero son incapaces de valerse por si mismos&#44; dependencia que ya la ten&#237;an&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Consideramos que la radiocirug&#237;a estereot&#225;xica empleando cobalto 60 &#40;Co 60&#41;&#44; es una alternativa a la extirpaci&#243;n quir&#250;rgica o a la simple observaci&#243;n cl&#237;nica y tomodensitom&#233;trica&#44; en pacientes ancianos o con patolog&#237;as graves asociadas&#46;</p>"
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        "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We present our initial experience with 5 patients treated for acoustic neurinoma by stereotactic radiosurgery using a Theratron 80 fitted to a stereotactic system&#44; during the last four years&#46; The average age of the patients was 70 years and alI of them suffered from associated serious pathology which prevented conventional surgery&#46; The tumours averaged 21<span class="elsevierStyleHsp" style=""></span>mm in diameter and the radiation doses delivered ranged from 2&#46;500 to 3&#46;750 cGy &#40;mean 2&#46;770 cGy&#41; and were administered in a single session&#46; The fields was 17&#44;8 and the diameter of the collimators averaged 20<span class="elsevierStyleHsp" style=""></span>m&#46; In cases 2 and 4 the 90&#37; isodose overtook the periphery of the tumour&#44; the 80&#37; isodose in case 5&#44; the 40&#37; isodose in case 3&#44; and in case 1 onIy the 20&#37; isodose overtook the perifery of the tumour&#46; Radiosurgery was well tolerated by all the patients&#46; The control CT scan showed centralloss of contrast enhancement in 2 patients&#44; and shrinkage of the tumor in 3&#46; One patient developed hydrocephalus and radionecrosis who required CSF shunting and corticoteroids&#46; The final outcome was as follows&#58; two patients presented a good evolution&#44; one patient developed a moderate disability and two more patients are unchanged but dependent&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Stereotactic radiosurgery is a good alternative to conventional surgery on nonsurgical management for patient with acoustic neurinoma who are elderly or medically ill&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Rubio Garc&#237;a&#44; E&#46;&#59; Casta&#241;o Duque&#44; C&#46;H&#46;&#59; Vilalta Cast&#225;n&#44; J&#46;&#59; Quesada Marin&#44; P&#46;&#59; Garc&#237;a Arumi&#44; A&#46;&#59; Guix Melcior&#44; B&#46;&#59; Bosch Blancafort&#44; J&#46;&#58; Neurinomas del ac&#250;stico tratados con radiocirug&#237;a estereot&#225;xica&#46; A prop&#243;sito de cinco casos&#46; Neurocirug&#237;a 1992&#59; 3&#58; 141&#8211;148&#46;</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotactic computed tomography"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Bergstrom"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.127.1.167"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR"
                        "fecha" => "1976"
                        "volumen" => "127"
                        "paginaInicial" => "167"
                        "paginaFinal" => "170"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/180828"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unilateral hypoglossal nerve atrophy as a late complication of radiation therapy of head and neck carcinoma&#58; a report of four cases and a review of the literature on peripheral and cranial nerve damages after radiation therapy"
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                        0 => array:2 [
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                          "autores" => array:2 [
                            0 => "V&#46;S&#46; Cheng"
                            1 => "M&#46;D&#46; Schulz"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1975"
                        "volumen" => "35"
                        "paginaInicial" => "1537"
                        "paginaFinal" => "1544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/167934"
                            "web" => "Medline"
                          ]
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                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonsurgical management of small and intracanalicular acoustic tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46;C&#46; Clark"
                            1 => "W&#46;H&#46; Moretz"
                            2 => "J&#46;D&#46; Acker"
                            3 => "L&#46;G&#46; Gardner"
                            4 => "F&#46; Eggers"
                            5 => "J&#46;H&#46; Robertson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1985"
                        "volumen" => "16"
                        "paginaInicial" => "801"
                        "paginaFinal" => "803"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4010902"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acoustic neurinoma surgery with emphasis on preservation of hearing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N&#46;L&#46; Cohen"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1288/00005537-197906000-00004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "1979"
                        "volumen" => "89"
                        "paginaInicial" => "886"
                        "paginaFinal" => "896"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/449534"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acoustic neuroma surgery&#58; an eclectic approach with emphasis on preservation of hearing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46;L&#46; Cohen"
                            1 => "P&#46; Hammerschlag"
                            2 => "H&#46; Berg"
                            3 => "J&#46; Ransohff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Otol Rhinol Larybgol"
                        "fecha" => "1986"
                        "volumen" => "95"
                        "paginaInicial" => "21"
                        "paginaFinal" => "27"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A critical comparison of neurosurgical and otolaringological approaches to acoustic neuromas"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;V&#46; Ditullio"
                            1 => "D&#46; Maldasian"
                            2 => "R&#46;W&#46; Rand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1978.48.1.0001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg"
                        "fecha" => "1978"
                        "volumen" => "48"
                        "paginaInicial" => "1"
                        "paginaFinal" => "12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/619009"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            14 => array:3 [
              "identificador" => "bib15"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radical intracapsular removal of acoustic neurinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;P&#46; Lownie"
                            1 => "C&#46;G&#46; Drake"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1991.74.3.0422"
                      "Revista" => array:7 [
                        "tituloSerie" => "J&#46; Neurosurg"
                        "fecha" => "1991"
                        "volumen" => "74"
                        "paginaInicial" => "422"
                        "paginaFinal" => "425"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1993907"
                            "web" => "Medline"
                          ]
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                          "pii" => "S0015028207030233"
                          "estado" => "S300"
                          "issn" => "00150282"
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                  ]
                ]
              ]
            ]
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              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hearing preservation after acoustic neurinoma operation"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:11 [
                            0 => "M&#46;D&#46; Frerebeau"
                            1 => "J&#46; Benezech"
                            2 => "A&#46; Uziel"
                            3 => "T&#46; Coubes"
                            4 => "F&#46; Segnaribieux"
                            5 => "M&#46; Malonga"
                            6 => "J&#46; Hearing"
                            7 => "A&#46; Uziel"
                            8 => "T&#46; Coubes"
                            9 => "F&#46; Senaribieux"
                            10 => "M&#46; Malonga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1987"
                        "volumen" => "21"
                        "paginaInicial" => "197"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3658132"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Middle cranial fossa acoustic neuroma excision&#58; Results and complications"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46;J&#46; Gantz"
                            1 => "L&#46;S&#46; Parnes"
                            2 => "L&#46;A&#46; Harkder"
                            3 => "B&#46;F&#46; McCabe"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
                        "fecha" => "1986"
                        "volumen" => "95"
                        "paginaInicial" => "454"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3767216"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonsurgical management of small and intracanalicular acoustic tumors"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Gardner"
                            1 => "W&#46;H&#46; Moretz"
                            2 => "J&#46;H&#46; Robertson"
                            3 => "C&#46; Clark"
                            4 => "J&#46;J&#46; Shea Jr&#46;"
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                        ]
                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
                        "fecha" => "1986"
                        "volumen" => "94"
                        "paginaInicial" => "328"
                        "paginaFinal" => "333"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3083361"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
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            18 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hearing preservadon in unilateral acoustic neuroma surgery"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Gardner"
                            1 => "J&#46;H&#46; Robertson"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
                        "fecha" => "1988"
                        "volumen" => "97"
                        "paginaInicial" => "55"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3277525"
                            "web" => "Medline"
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                          "pii" => "S1521691802903148"
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                          "issn" => "15216918"
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                ]
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            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systematic approach to the surgical management of acoustic neuroma"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;E&#46; Glasscock"
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                            2 => "S&#46;C&#46; Levine"
                            3 => "C&#46;G&#46; Jackson"
                            4 => "K&#46;X&#46; Mckennan"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
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                        "volumen" => "96"
                        "paginaInicial" => "1088"
                        "paginaFinal" => "1094"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3531748"
                            "web" => "Medline"
                          ]
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            20 => array:3 [
              "identificador" => "bib21"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Audiologic findings after stereotactic radiosurgery in nine cases of acoustic neurinomas"
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                          "etal" => false
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                            0 => "A&#46; Hirsch"
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                            2 => "H&#46; Anderson"
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Otolaryngol &#40;Sotckh&#41;&#46;"
                        "fecha" => "1979"
                        "volumen" => "88"
                        "paginaInicial" => "155"
                        "paginaFinal" => "160"
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                ]
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            21 => array:3 [
              "identificador" => "bib22"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral acoustic tumors and neurofibromatosis"
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                            0 => "W&#46;E&#46; Hitselberger"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol"
                        "fecha" => "1968"
                        "volumen" => "88"
                        "paginaInicial" => "700"
                        "paginaFinal" => "711"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4972899"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chemotherapy of bilateral acoustic neuromas"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
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                        "volumen" => "98"
                        "paginaInicial" => "273"
                        "paginaFinal" => "282"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3132678"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The gammaKnife an alternative treatment for neurinomas"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
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                        "volumen" => "97"
                        "paginaInicial" => "631"
                        "paginaFinal" => "635"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3059942"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intracanalicular neurilemmomas&#58; Clinicopathology study"
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                          "etal" => false
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                            0 => "V&#46; Kasantikul"
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                            3 => "J&#46;W&#46; Hayes"
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                    0 => array:1 [
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                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
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                        "paginaInicial" => "29"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7356262"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Acoustic neurilemoma&#58; Clinicoanatomical study of 103 patients"
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                    0 => array:2 [
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                        "tituloSerie" => "J&#46; Neurosurg"
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                        "paginaFinal" => "35"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7350277"
                            "web" => "Medline"
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                ]
              ]
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            26 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Investigation of patients presenting with cerebellopontine angle syndromes"
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuroradiology"
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                        "volumen" => "13"
                        "paginaInicial" => "65"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/301254"
                            "web" => "Medline"
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                ]
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            27 => array:3 [
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Translabyrinthic and transtentorial removal of acoustic nerve tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;T&#46; King"
                            1 => "A&#46;W&#46; Morrison"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Operative Surgery &#40;Neurosurgery&#41;"
                        "paginaInicial" => "355"
                        "paginaFinal" => "363"
                        "edicion" => "Forth Edition"
                        "serieFecha" => "1989"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isoeffective dose parameters for brain necrosis in relation to proton radiosurgical dosimetry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;N&#46; Kjellberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Stereotactic Cerebral Irradiation"
                        "paginaInicial" => "157"
                        "paginaFinal" => "166"
                        "serieFecha" => "1979"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Volume growth rate of acoustic neurinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;M&#46; Laasonen"
                            1 => "H&#46; Troupp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuroradiology"
                        "fecha" => "1986"
                        "volumen" => "28"
                        "paginaInicial" => "203"
                        "paginaFinal" => "207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3725008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Special stereotactic techniques&#58; Stereotactic radiosurgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;G&#46; Leksell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Stereotactic Neurosurgery"
                        "paginaInicial" => "195"
                        "paginaFinal" => "209"
                        "serieFecha" => "1988"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The stereotactic method and radio surgery of the brain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Leksell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Chir Scand"
                        "fecha" => "1951"
                        "volumen" => "102"
                        "paginaInicial" => "316"
                        "paginaFinal" => "319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14914373"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A note on the treatment of acoustic tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Leksell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Chir Scand&#46;"
                        "fecha" => "1971"
                        "volumen" => "137"
                        "paginaInicial" => "763"
                        "paginaFinal" => "765"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4948233"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotaxis and tomography&#58; A technical note"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Leksell"
                            1 => "B&#46; Jernberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1980"
                        "volumen" => "52"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotaxis and nuclear magnetic resonance&#58; Technical note"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Leksell"
                            1 => "D&#46; Leksell"
                            2 => "J&#46; Schwebel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurol Neurosurg Psychiatry"
                        "fecha" => "1985"
                        "volumen" => "48"
                        "paginaInicial" => "14"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3882889"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiosurgery for Acoustic neurinomas&#46; Early experiencie"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;E&#46; Linskey"
                            1 => "L&#46;D&#46; Lunsford"
                            2 => "J&#46;C&#46; Flickinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1990"
                        "volumen" => "vol&#46; 26"
                        "paginaInicial" => "736"
                        "paginaFinal" => "745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12925258"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unusual audiometric and histolog&#237;c findings in bilateral acoustic neurinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;H&#46; Linthicum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
                        "fecha" => "1972"
                        "volumen" => "81"
                        "paginaInicial" => "433"
                        "paginaFinal" => "437"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4624134"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Select a surgical approach for removal of acoustic schwannoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;M&#46; Long"
                            1 => "D&#46;W&#46; Kennedy"
                            2 => "M&#46;J&#46; Holliday"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ear Nose Throat J"
                        "fecha" => "1986"
                        "volumen" => "65"
                        "paginaInicial" => "163"
                        "paginaFinal" => "173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3720599"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotactic Radiosurgery of the brain using the first United States 201 cobalt-60 source gamma knife"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;D&#46; Lundsford"
                            1 => "J&#46; Flickinger"
                            2 => "G&#46; Lindner"
                            3 => "A&#46; Maitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1989"
                        "volumen" => "24"
                        "paginaInicial" => "151"
                        "paginaFinal" => "159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2645538"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "First United States 201 source cobalt-60 gamma knife unit for radiosurgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;D&#46; Lunsford"
                            1 => "A&#46; Maitz"
                            2 => "G&#46; Lindner"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Appl Neurophysiol"
                        "fecha" => "1987"
                        "volumen" => "50"
                        "paginaInicial" => "253"
                        "paginaFinal" => "256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3329857"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereoctactic surgery with a magnetic resonance and computerized tomography compatible system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;D&#46; Lunsford"
                            1 => "A&#46;J&#46; Martinez"
                            2 => "R&#46;E&#46; Latchaw"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1986.64.6.0872"
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg"
                        "fecha" => "1986"
                        "volumen" => "64"
                        "paginaInicial" => "872"
                        "paginaFinal" => "878"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3009738"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influencie of volume on the tolerance of the brain to radiosurgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;B&#46; Marks"
                            1 => "D&#46;P&#46; Spencer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1991.75.2.0177"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1991"
                        "volumen" => "75"
                        "paginaInicial" => "177"
                        "paginaFinal" => "180"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2072155"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral acoustic neuromas&#46; Clinical aspects and teatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;L&#46; Martuza"
                            1 => "R&#46;G&#46; Ojemann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1982"
                        "volumen" => "10"
                        "paginaInicial" => "1"
                        "paginaFinal" => "12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7057963"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sensori-neural hearing loss following radiotherapy to the nasopharynx"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Moretti"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1288/00005537-197604000-00018"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "1976"
                        "volumen" => "86"
                        "paginaInicial" => "598"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1263730"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preservation of hearing in surgical removal of acoustic neuromas of the internal auditory canal and cerebellar pontine angle"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "J&#46;B&#46; Nadol"
                            1 => "R&#46; Levine"
                            2 => "R&#46;L&#46; Martuza"
                            3 => "R&#46;G&#46; Ojemann"
                            4 => "W&#46; Montgomery"
                            5 => "D&#46;E&#46; Klevens"
                            6 => "P&#46; Sandoval"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1288/00005537-198711000-00007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "1987"
                        "volumen" => "97"
                        "paginaInicial" => "1287"
                        "paginaFinal" => "1294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3499554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is no treatment good in the managent of acoustic neuromas in the elderly&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Nedzelski"
                            1 => "R&#46;J&#46; Canter"
                            2 => "D&#46;W&#46; Rowed"
                            3 => "E&#46;E&#46; Kassel"
                            4 => "C&#46;H&#46; Tator"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "1986"
                        "volumen" => "96"
                        "paginaInicial" => "825"
                        "paginaFinal" => "882"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3736295"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "47&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The incidence of acoustic neuromas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;J&#46; Nestor"
                            1 => "H&#46;W&#46; Korol"
                            2 => "S&#46;L&#46; Nutil"
                            3 => "R&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Arch Otoaryngol Head Neck Surg"
                        "fecha" => "1988"
                        "volumen" => "114"
                        "paginaInicial" => "680"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib48"
              "etiqueta" => "48&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotactic radiosurgery in cases of acoustic neurinoma&#58; further experiences"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Noren"
                            1 => "J&#46; Arndt"
                            2 => "T&#46; Hindmarsch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1983"
                        "volumen" => "13"
                        "paginaInicial" => "12"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6348580"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of intraoperative auditory evoked potentials to preserve hearing in unilateral acoustic neuroma removal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;G&#46; Ojemann"
                            1 => "R&#46;A&#46; Levine"
                            2 => "M&#46; Montomery"
                            3 => "P&#46; Mcgassigan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1984.61.5.0938"
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg"
                        "fecha" => "1984"
                        "volumen" => "61"
                        "paginaInicial" => "938"
                        "paginaFinal" => "948"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6491737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib50"
              "etiqueta" => "50&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Which small acoustic neuromas need surgery&#63; The influence of magnetic resonance and air CT meatograms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;D&#46; Phels"
                            1 => "G&#46;A&#46; Lloyd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol"
                        "fecha" => "1987"
                        "volumen" => "12"
                        "paginaInicial" => "191"
                        "paginaFinal" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3608209"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib51"
              "etiqueta" => "51&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cranial nerve damage in patients after &#40;heavy&#41;-particle radiation to the pituitary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Price"
                            1 => "W&#46;C&#46; Wei"
                            2 => "C&#46;L&#46;Y&#46; Chong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ophthalmology"
                        "fecha" => "1979"
                        "volumen" => "86"
                        "paginaInicial" => "1161"
                        "paginaFinal" => "1170"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/230438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib52"
              "etiqueta" => "52&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Rhoton AL&#46;&#58; Editorial comment following&#58; Noren G&#46;&#44; Ardt J&#46;&#44; Hindmarsch T&#46;&#58; Stereotactic radiosurgery 1983&#59; 13&#58; 12&#8211;22&#46;"
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib53"
              "etiqueta" => "53&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapeutic irradiation and brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;E&#46; Sheline"
                            1 => "W&#46;M&#46; Wara"
                            2 => "V&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J&#46; Radiat Oncol Biol Phys"
                        "fecha" => "1980"
                        "volumen" => "6"
                        "paginaInicial" => "1215"
                        "paginaFinal" => "1228"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7007303"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib54"
              "etiqueta" => "54&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hearing preservation after acoustic neuroma surgery with intraoperative direct eight cranial nerve monitoring&#58; Part II&#46; A&#46; classification of results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Silverstein"
                            1 => "A&#46; McDaniel"
                            2 => "H&#46; Norrell"
                            3 => "T&#46; Haberkamp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
                        "fecha" => "1986"
                        "volumen" => "95"
                        "paginaInicial" => "285"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3108775"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib55"
              "etiqueta" => "55&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotactic Radiosurgery of small intracranial tumors&#58; Neuropathological correlation in three patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46;G&#46; Thompson"
                            1 => "R&#46;J&#46; Coffey"
                            2 => "J&#46;C&#46; Flickinger"
                            3 => "L&#46;D&#46; Lunsford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "1990"
                        "volumen" => "33"
                        "paginaInicial" => "96"
                        "paginaFinal" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2154869"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib56"
              "etiqueta" => "56&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of acoustic neuromas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Tos"
                            1 => "J&#46; Thombsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Laryngol Otol"
                        "fecha" => "1984"
                        "volumen" => "98"
                        "paginaInicial" => "685"
                        "paginaFinal" => "692"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6747450"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib57"
              "etiqueta" => "57&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hearing preservation in patients with acoustic neuromas via the middle fossa approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;J&#46; Wade"
                            1 => "W&#46; House"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
                        "fecha" => "1984"
                        "volumen" => "92"
                        "paginaInicial" => "184"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6425773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib58"
              "etiqueta" => "58&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of irradiation for incompletely excised acoustic neurilemomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;E&#46; Wallner"
                            1 => "G&#46;E&#46; Sheline"
                            2 => "L&#46;H&#46; Pitts"
                            3 => "W&#46;M&#46; Wara"
                            4 => "R&#46;L&#46; Davis"
                            5 => "E&#46;B&#46; Bolpray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1987.67.6.0858"
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg"
                        "fecha" => "1987"
                        "volumen" => "67"
                        "paginaInicial" => "858"
                        "paginaFinal" => "863"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3681424"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib59"
              "etiqueta" => "59&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tanstemporal planned partial resecction of bilateral acoustic neurinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;E&#46; Wigand"
                            1 => "W&#46; Geortzen"
                            2 => "M&#46; Berg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1988"
                        "volumen" => "92"
                        "paginaInicial" => "50"
                        "paginaFinal" => "54"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib60"
              "etiqueta" => "60&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tumors of peripheral and sympathetic nerves"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;R&#46; Youmans"
                            1 => "W&#46;Y&#46; Ishida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Neurological surgery"
                        "paginaInicial" => "3299"
                        "paginaFinal" => "3315"
                        "edicion" => "second Edition"
                        "serieFecha" => "1982"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Vol. 3. Núm. 2.
Páginas 141-148 (enero 1992)
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Vol. 3. Núm. 2.
Páginas 141-148 (enero 1992)
Neurinomas del acústico tratados con radiocirugía estereotáxica. A propósito de cinco casos
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E. Rubio García, C.H. Castaño Duque, J. Vilalta Castán, J. Bosch Blancafort
Servicio de Neurocirugía, Hospital Vall d’Hebrón. Barcelona
P. Quesada Marin*, A. García Arumi*, B. Guix Melcior**
* Servicio de ORL, Hospital Vall d’Hebrón. Barcelona
** Servicio de Radioterapia, Clínica Dexeus. Barcelona
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Resumen

Exponemos nuestra experiencia en el tratamiento de los neurinomas del acústico con radiocirugía, mediante un aparato de telecobaltoterapia (Theraton 80), acoplado a un sistema de esterotáxia, en cinco pacientes ancianos, cuya edad promedio fue de 70 años. Todos ellos presentaban patologías graves asociadas que impedían el tratamiento quirúrgico. El diámetro promedio del tumor era de 21mm. Se administró radioterapia (Radiocirugía), con una dosis promedio de 2.770 cGy (rango 2500 a 3750 cGy) en una sola sesión, mediante un promedio de 17,8 campos isocéntricos con un colimador de 20mm. de diámetro. La repartición de la isodosis se hizo de la siguiente manera: en los casos 2 y 4 el 90% de la isodosis alcanzó la periferia del tumor, en el caso 5 el 80%, en el caso 3 el 40%, mientras que en el caso 1, sólo el 20% de la isodosis alcanzó la periferia del tumor. La radiación fue bien tolerada por todos los pacientes. La TAC de control puso de manifiesto la disminución del tamaño de la lesión en 3 pacientes y la aparición de una zona hipodensa central en 2. Un paciente desarrollo hidrocefalia y radionecrosis de cerebelo que precisó derivación del LCR y tratamiento con corticoides. Dos pacientes tuvieron una buena recuperación, otro tenía una moderada incapacidad y 2 se han estabilizado, pero son incapaces de valerse por si mismos, dependencia que ya la tenían.

Consideramos que la radiocirugía estereotáxica empleando cobalto 60 (Co 60), es una alternativa a la extirpación quirúrgica o a la simple observación clínica y tomodensitométrica, en pacientes ancianos o con patologías graves asociadas.

Palabras clave:
Radiocirugía
Radioterapia
Radiocirugía Estereotáxica
Neurinoma del acústico
Radionecrasis
Hidrocefalia
Summary

We present our initial experience with 5 patients treated for acoustic neurinoma by stereotactic radiosurgery using a Theratron 80 fitted to a stereotactic system, during the last four years. The average age of the patients was 70 years and alI of them suffered from associated serious pathology which prevented conventional surgery. The tumours averaged 21mm in diameter and the radiation doses delivered ranged from 2.500 to 3.750 cGy (mean 2.770 cGy) and were administered in a single session. The fields was 17,8 and the diameter of the collimators averaged 20m. In cases 2 and 4 the 90% isodose overtook the periphery of the tumour, the 80% isodose in case 5, the 40% isodose in case 3, and in case 1 onIy the 20% isodose overtook the perifery of the tumour. Radiosurgery was well tolerated by all the patients. The control CT scan showed centralloss of contrast enhancement in 2 patients, and shrinkage of the tumor in 3. One patient developed hydrocephalus and radionecrosis who required CSF shunting and corticoteroids. The final outcome was as follows: two patients presented a good evolution, one patient developed a moderate disability and two more patients are unchanged but dependent.

Stereotactic radiosurgery is a good alternative to conventional surgery on nonsurgical management for patient with acoustic neurinoma who are elderly or medically ill.

Key words:
Radiosurgery
Radiotherapy
Stereotactic Radiosurgery
Acoustic Neurinoma
Radionecrosis
Hydrocephalus

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