ObjectiveThe clinical effects and surgical procedures of Hogan posterior pharyngeal flap in the treatment of the older patients with velopharyngeal insufficiency (VPI) after cleft palate repair were investigated.MethodsA total of 33 patients (aged 10-35 years; average of 20.4 years) with VPI secondary to cleft palate were included. They underwent Hogan posterior pharyngeal flap to improve velopharyngeal closure function. The clinical efficacy of the ope-ration was evaluated with Chinese speech clarity measurement and nasopharyngeal fiberscope (NPF), and the velopharyngeal closure was graded. The average follow-up time was 13.3 months.ResultsThe wounds of all patients were healed by first intention, and speech assessment showed that the consonant articulation increased and the rate of hypernasality and nasal emission decreased significantly (P<0 .05). npf examination showed that the postoperative velopharyngeal closure function significantly improved, 30 cases (91%) were gradeⅰ, and 3 cases (9%) were grade ⅱ.ConclusionHogan posterior pharyngeal flap for VPI secondary to cleft palate can significantly improve velopharyngeal closure.