{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:30:53Z","timestamp":1789587053957,"version":"build-2803163510"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate operative experiences and perspectives of surgeons presented with cleft lip (CL) and\/or palate (CP) in children with life-limiting and terminal illnesses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Survey study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Electronic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>American Cleft Palate Craniofacial Association surgeon members.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Proportion of surgeons who performed cleft lip and\/or palate (CL\/P) repair, likelihood to operate again, and factors impacting operative decision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Response rate was 20.5% (121\/589) including 113 surgeons treating CL\/P across plastic surgery (63.7%), otolaryngology (23.9%), and oral and maxillofacial surgery (12.4%). More completed CL than CP repairs (59.3% vs 21.2%) for patients with example conditions of holoprosencephaly, cardiac abnormalities, trisomy 13, and trisomy 18. Leading CL repair motivations were \u201cparent\/caregiver request\u201d (89.6%, 60\/67), \u201cappearance\u201d (62.7%, 42\/67), and \u201cfeeding\u201d (28.4%, 19\/67). Leading CP repair motivations were \u201cparent\/caregiver request\u201d (66.7%, 16\/24), \u201cfeeding\u201d (62.5%, 15\/24), and \u201ccommunication\u201d (54.2%, 13\/24). Surgeons who had not attempted CL repair described lacking opportunity (34.8%, 16\/46) or unfavorable risk\u2013benefit ratios (37.0%, 17\/46) as reasons. A greater proportion of those who had not attempted CP repair cited unfavorable risk\u2013benefit ratios (59.6%, 53\/89) versus lacking opportunity (21\/89, 23.6%). 100% and 95.8% who repaired CL and CP endorsed they would again.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgeons more commonly repaired CL than CP in children with life-limiting and terminal illnesses. Nearly all would perform these surgeries again. Respondents who did not repair CP often stated risks outweighed benefits. Studies exploring outcomes of CL\/P repair in patients with life limiting and terminal illnesses are scarce. More data are needed to help guide these difficult decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251407596","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T19:04:33Z","timestamp":1766171073000},"page":"454-462","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgeon Perspectives on Cleft Lip and Palate Repair in Patients With Life-Limiting and Terminal Illnesses: An ACPA Member Survey"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3121-2343","authenticated-orcid":false,"given":"Lauren E.","family":"Sullivan","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7233-3450","authenticated-orcid":false,"given":"Noah 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