The "chronic" ear: how to manage mild to severe otitis.

Otitis media initially involves only the mucosa, but if unchecked, may eventually spread to bone, causing bony erosion and severe osteitis that can have life-threatening CNS complications. Placement of a PE tube generally is all that is necessary to eliminate middle ear fluid and restore normal hearing in serous otitis media and adhesive otitis media. Mastoidectomy is required in more advanced chronic ear disease; if disease is not too extensive, hearing may be restored by tympanoplasty.