Munson PD, et al. - Authors perform this work to assess if children with velopharyngeal insufficiency (VPI) treated by augmentation pharyngoplasty (AP) with calcium hydoxylapatite (CaHa) demonstrate clinically significant improvement in speech outcomes. They realize that in properly selected patients, AP with CaHa is a safe, minimally invasive, enduring treatment for VPI. Significant improvement was observed in nasality and speech scores, especially in patients with isolated VPI.