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Facial nerve surgery inevitably leads to partial pareses,
abnormally associated movements and pathologically altered
reflexes. The reason for this "post-paralytic syndrome" is the
misdirected reinnervation of targets, which consists of two major
components. First, due to malfunctioning axonal guidance, a muscle
gets reinnervated by a "foreign" axon, that has been misrouted
along a "wrong" fascicle. Second, the supernumerary collateral
branches emerging from all transected axons simultaneously
innervate antagonistic muscles and cause severe impairment of their
coordinated activity. Since it is hardly possible to influence the
first major component and improve the guidance of several thousands
axons, the authors concentrated on the second major component and
tried to reduce the collateral axonal branching.
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