introduction: otitis media with effusion (ome) is a frequent finding in patients with cleft palate due to a functional obstruction of the eustachian tube. because of its association with hearing loss and low rate of spontaneous resolution the use of ventilation tubes as treatment appears as beneficial the clinical and audiological consequences of this conduct areinot well established. aim: to compare anatómical and audiologics results with two strategies of treatment. material ana method: historical cohort study of children from 8 to 10 years, with cleft palate, surgically corrected, and with ome. one group was treated with ventilation tubes, and an expectant management was carried out with the other group. the following parameters were compared by xi-square test and fischer: tympanic membrane state, presence of compiications and hearing level. results: fifty six patients were admitted, 24 in surgical management and 32 in conservative. every child had a cleft palate corrected without velopharyngeal insufficiency it was found a higher frequency of tympanic membrane retraction, tympanic membrane perforation and hearing loss in the case groups were found. discusion: we found a greater presence of tympanic alterations and hearing disorders in patients subjected to ventilation tubes as treatment of ome. it seems prudent to evalúate the surgical alternative individually according to each patient characteristic.