17 after, submandibular 2-duct ligation (2-DL) and 3-duct ligation (ligation of both submandibular ducts and one parotid duct) were reported in the literature. Similar to botulinum toxin injections, 2-DL is a short intervention that takes place in an outpatient setting (Figure 1). The complications after 2-DL seem limited and the success rate of duct ligation in the short term seems only slightly inferior to SMDR and SMGE. Long-term results are, however, ambiguous because recurrence varies between 0 and 58%. Studies yet available are of limited methodological quality and describe relatively small numbers of patients (15 and 12 patients).52, 53 Figure 1. Illustration of the postoperative status after submandibular duct ligation. Duct ligation would appear to have several advantages compared to SMDR and SMGE because it is a significantly shorter surgical procedure (including less extensive dissection) and thus a potentially lower risk for adverse events and complications. However, results in the medium to long-term are not as well established as for SMDR and SMGE. Objectives The primary purpose of this thesis is to study the efficacy of 2-duct ligation (2-DL) to define its position in the palette of interventional treatment for drooling. Recent publications have demonstrated promising results of 2-DL due to its limited invasiveness, limited morbidity, and significant drooling reduction. However, its
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