The middle ear needs air. Without a working Eustachian tube, the small amount of air behind the eardrum is gradually absorbed, pressure falls, the drum is drawn inward, and fluid seeps in to fill the space. In children, the result is glue ear, with dulled hearing at the age when language is developing, which is why ventilation tubes are among the most common operations performed in that age group.
A tube through the drum provides a direct air path. It does not treat the Eustachian tube or make it work again. It simply removes the consequence of it not working, for as long as the tube stays in place. Most eventually extrude on their own as the drum heals and pushes them out, which is why retention period is the variable a surgeon weighs against how long the problem is expected to last.
Material choice sits behind that. A tube that is going to remain for years faces a longer exposure to moisture, bacteria and the drum's own migration than one designed to fall out within twelve months, and the properties that matter change accordingly. Titanium is hard-wearing and highly biocompatible, and unlike some metal alternatives, it is not magnetic, so imaging is unaffected while the tube is in place. But it doesn't remove the fundamental trade-off.
A wider lumen ventilates and drains more freely but leaves a larger hole to heal when the tube eventually comes out. Medigear.uk supplies the instructions for use with every order.

