Nasalance scores were measured with a model 6200 Nasometer in 28 patients with cleft palates and 8 patients with signs of velopharyngeal insufficiency but no cleft palate, both before and after a modified Honig velopharyngeal flap operation. The nasalance measurements were compared with subjective speech assessments. Patients were assessed as normal or borderline if their scores were < 30, and as having hypernasal speech if the score was > 29. The overall scores were improved by operation from a mean (SD) of 47 (13) to 26 (12). It was concluded that a modified Honig velopharyngeal flap is effective in eliminating hypernasality as defined by the nasalance scores.