Paolo Castelnuovo

Iacopo Dallan

Manfred Tschabitscher

Surgical Anatomy of the

Internal Carotid Artery

An Atlas for

Skull Base Surgeons

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Foreword

All truths are easy to understand once they are discovered; the point is to discover them.

Galileo Galilei (1564–1642)

When running through the pages of the manuscript of this atlas for the first time, I could not find words to describe the stunning beauty of the images with their fascinating attention to detail, their unseen-before quality of anatomical preparation and dissection, the precision of both photographic as well as schematic documentation and explanations—and my first impression was:

What a piece of masterly art!

Dissecting the internal carotid artery along its different segments in high quality, explaining the topographical relations in each of them, is one achievement the authors have met with excellence: to integrate and display views of different surgical corridors into their dissection opens “windows of opportunity” for skull base surgeons that have been explored over the last decade by a few—and shall I say daring?—expert surgeons only. This book makes available to all who are interested in skull base surgery the complexity of anatomy, yet at the same time the beauty of it: I consider this atlas a milestone in the history of endoscopic and other skull base surgery. The authors have to be congratulated for this masterpiece, which will become the gold standard for experts and beginners, for surgeons and anatomists, as well as for radiologists instantly:

Can one desire too much of a good thing?

William Shakespeare: As you like it

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Preface

Sine anatomia non sciemus

Knowledge of human anatomy is one of the bases for the exercise of medicine. The considerable growth of core disciplines such as physiology, genetics, and immunology has led to major development of the teaching of these disciplines over the past 20 years, increasingly limiting the teaching of anatomy, which is sometimes considered a “too old” discipline. At the same time, during the last decade the growth and development of new surgical techniques (especially endoscopically assisted ones) and their everyday application has been phenomenal. This dichotomy is probably the most important reason for this book: Although we could be wrong, we strongly believe that there is a pressing need for a text atlas that provides essential (but not excessive) information pictorially accompanied by cadaveric correlation. In other words, an atlas that is simple, concise, and informative.

This book covers the relevant anatomy of the regions surrounding the internal carotid artery, which is the “queen structure” of the whole skull base. Arbitrarily, the book has been divided into three parts focusing on different segments of the internal carotid artery: the cervical, the skull base, and the intracranial. The text of each chapter is deliberately simple and clear, and the illustrations offer a three-dimensional multiperspective representation of the regions, with direct correlation to neuroradiological imaging.

Philosophically speaking, we are strongly convinced that there exists only one anatomy—but several ways of looking at it. So, all the effort has been directed toward offering a multiperspective visualization of the anatomic fields to create a three-dimensional, truly orienting vision of the spaces.

We wish to express our deep gratitude to all our coworkers for the support, help, and encouragement shown throughout the project.

We hope that this new anatomic atlas, deliberately dedicated to clinical and practical application, meets the modern requirement of simplification to the essential and will serve as a necessary step toward new surgical approaches. But above all, we hope that it will be a useful tool for all those who are involved in the fascinating field of skull base surgery.

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