SummaryA survey of 26 patients who have had modified Orticochea pharyngoplasty to alleviate problems of velopharyngeal incompetence has been made.Tape recordings at pre‐operative stage and at three months and 12 months postoperatively were assessed by a group of speech therapists who were not involved in the management of these patients. Their opinions are published in the Tables enclosed.It is felt that this modified Orticochea procedure offers several advantages over more traditional techniques, but that there still remains considerable scope for further improvement, especially for those patients who start off with an exceptionally severe degree of nasal escape and the resulting defects in articulatio