Background/Objectives: Carotid body paragangliomas, commonly referred to as Carotid Body Tumors (CBTs), are rare, highly vascular paragangliomas arising at the carotid bifurcation and pose significant surgical challenges due to their proximity to critical neurovascular structures. Optimal management remains debated, particularly for large or complex lesions. This study aims to present a structured neurosurgical operative workflow as an educational and practical resource to help young surgeons understand operative decision-making and technical execution from a neurosurgical perspective. Methods: We retrospectively reviewed patients diagnosed with CBTs and identified three cases that underwent microsurgical resection by a single neurosurgeon. Clinical presentation, radiographic findings, operative strategies, intraoperative microsurgical techniques, and postoperative outcomes were analyzed. Surgical procedures for all three cases are further illustrated with technical video demonstrations highlighting meticulous microsurgical techniques performed by a single neurosurgeon. Results: All three patients presented with either incidental or slowly progressive neck masses, with imaging demonstrating classic splaying of the internal and external carotid arteries. One patient exhibited elevated catecholamine metabolites, while another had a familial history of paragangliomas. Preoperative embolization was successfully performed in all three cases. Complete tumor resection was achieved in each patient. One patient developed post-embolization embolic ischemic changes with transient neurological deficits that were resolved within several hours. No permanent cranial nerve deficits, vascular injuries, or tumor recurrences were observed. Pathology confirmed paraganglioma in all cases. Conclusions: Surgical resection remains an effective treatment for CBTs, which are commonly managed by vascular or head and neck surgeons. This case series illustrates the technical feasibility of CBT resection using a comprehensive neurosurgical strategy that integrates endovascular preparation, cerebral perfusion assessment, and meticulous microsurgical technique. Rather than proposing novel surgical innovation, this report aims to provide a structured operative framework and detailed video-based illustration of complex carotid bifurcation management from a neurosurgical perspective.

BACKGROUND AND OBJECTIVES: Thorough and objective assessment is of utmost importance for any microsurgical laboratory training, allowing trainees to identify areas needing further improvement. The ideal assessment tool should be objective, reliable, self-administered, and easy to implement. Building on this necessity, the aim of this study was to establish an objective, reliable, and self-administered assessment tool for microsurgical laboratory training, enabling trainees to independently practice and assess their own results. METHODS: Eight trainees completed the Baskaya Microvascular Bypass Training Curriculum using a basic microsurgery training kit. Each trainee evaluated their 31 end products twice with the newly introduced Madison Objective Self-Assessment Tool (MOST). Subsequently, the same expert independently evaluated each trainee's end products once. These 3 sets of evaluations were compared using the intraclass correlation coefficient (ICC) to determine the reliability of the new self-assessment tool, both intrarater and interrater. RESULTS: The findings demonstrated that, aside from 2 exercises, the agreement levels for both interrater and intrarater ranged from excellent (ICC >0.90) to acceptable (ICC = 0.61-0.80). For the silicone tube (2 mm) end-to-end anastomosis with 9-0, the interrater ICC showed fair agreement, at 0.32 [−0.10 to 0.63], and for the chicken vessels side-to-side anastomosis with 10-0, interrater ICC demonstrated moderate agreement at 0.52 [0.16-0.76]. These results underscore the reliability of MOST. In addition, participant feedback highlighted its ease of use, requiring merely a few minutes to evaluate each end product. CONCLUSION: This study has demonstrated that the MOST is an effective, objective, and reliable tool for self-evaluation in microvascular anastomosis training, demonstrating high levels of agreement across most exercises and offering a user-friendly experience for trainees. This underscores its suitability as a valuable resource for enabling self-driven microvascular anastomosis training and assessment, especially in places where expert evaluation is unavailable.