The Impact of COVID-19 on Cleft Surgery in Guatemala: A Decade at Hospital de Obras Sociales del Santo Hermano Pedro.

ObjectiveTo assess the demographic patterns, surgical volume, and COVID-19 effect on cleft lip and/or palate (CL/P) patients at a mission-based hospital, providing insight into the burden of cleft care and the role of global outreach in resource-limited settings.DesignRetrospective cohort study.SettingSocial aid hospital in Guatemala.PatientsPatients undergoing CL/P surgery between July 2014 and December 2024.InterventionsSurgical missions for CL/P.Main Outcome MeasurePrimary outcomes included surgical volume, geographic distribution of patients, and age at primary surgery.ResultsOver 10 years, 2010 CL/P patients were treated by 98 surgeons. Patients ranged from 11 months to 73 years (mean age 7.4 years); 64% were male. The most common conditions were unilateral cleft lip (38.4%), cleft palate (28.2%), and cleft palate with unilateral cleft lip (19.2%). Patients came from 18 of Guatemala's 22 departments. Surgical volume declined during the pandemic but rebounded in 2021, reaching the highest volume of patients treated. The average age at primary surgery decreased significantly over time, from 9.9 years pre-COVID to 4.9 years during the pandemic and 3.8 years post-COVID (P < .001).ConclusionOur institution provides essential cleft care to underserved populations across Guatemala. Even with disruptions caused by the pandemic, surgical delivery continued to improve. These findings reflect the hospital's ability to adapt and illustrate how mission-based models can continue improving timely surgical access over time. Efforts to further reduce treatment delays and expand follow-up care remain essential to optimizing cleft outcomes.