Microsurgical velopharyngeal reconstruction. Evaluation of 37 patientsBackground: Velopharyngeal reconstruction after surgical excision of tumors is complex and must preserve swallowing and phonation Aim: To assess quality of life of patients subjected to velopharyngeal reconstruction after excision of a pharyngeal carcinoma. To propose a new classification velopharyngeal junction defects, based on tridimensional criteria, to allow a reconstruction using radial forearm flaps. Material and Methods: Prospective evaluation of 37 patients aged 25 to 78 years, with a carcinoma that involved the lateral wall of the oropharynx or soft palate, subjected to surgical excision with negative surgical margins. Four types of velopharyngeal effects were considered for reconstruction. In 25 of the patients quality of life and quality of swallowing and phonation was evaluated. Results: Eighty one percent of patients considered their quality of life as good or optimal. No patients had swallowing disturbances and 71, 21 and 8% had an excellent, good or acceptable phonetic results, respectively. Conclusions: The proposed classification allows a reconstruction without tension and with a good functional performance.