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The rarely occurring type II-IV synkinesis should, whenever possible, be transformed into a more favorable type I synkinesis by selective or non-selective reinnervation at an early stage of the disease. The latter applies to expected muscle atrophy with insufficient regrowth of nerve fibers.The objectives of this chapter are to discuss the factors involved in the decision-making algorithm of an appropriate intervention for glottal insufficiency. Management strategies not only depend on the etiology, history, symptoms, size of glottal ga
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