The early management of ear disease in patient with cleft palate is to provide adequate hearing and maintain an adequate middle ear space untill the patient develops adequate eustachian tube function. Myringotomy or ventillation tube insertion was done simulatneosly with cleft lip or palate surgery on 62 cleft palate patients from May 1992 to Dec, 1993 at Hanyang University Hospital. Pre and postoperative otoscopic examination and impedance audiometry were performed, and the authors obtained the following results by analyzing theses data. 1) Among 124 ears of cleft palate patients, middle ear effusion was found in 87 ears(70%) by dianostic myringotomy. 2) Myringotomy with ventilation tube insertion was done in 67 ears(54%) and myringotomy alone in 57 ears (46%) with no or trace of serous fluid cases. 3) During follow-up period over 6 months, effusion was noted in 40 ears(70%) among myringotomy alone group. So, aggressive treatment was required in these cases which no or trace of fluid was noted at operation and treated with only myringotomy.