AbstractBackground.Measurement of functional outcomes related to different methods of soft palate reconstruction is necessary to determine efficacy of surgical intervention after resection for oropharyngeal cancer.Methods.Speech data were collected across 4 evaluation times for 4 groups of patients (2 groups consisted of patients with ≤ half the soft palate resected followed by conventional reconstruction; 2 groups consisted of patients with half or more of the soft palate resected followed by reconstruction with an adhesion or the soft palate insufficiency repair (SPIR).Results.Sixty‐two patients were included. Speech was preserved when conventional reconstructive procedures were used to close smaller defects. For larger defects, reconstruction with an adhesion resulted in poorer speech outcomes than the SPIR. The SPIR group achieved normal speech results at all points of evaluation.Conclusions.The results demonstrate that the SPIR is emerging as an efficacious surgical technique for reconstruction of larger soft palate defects. © 2008 Wiley Periodicals, Inc. Head Neck, 2008