There are two ways of repairing a perforation.
Myringoplasty – Placing a patch over the perforation. This is generally acceptable for small perforations, perforations away from the ear canal, and small amount of hearing loss.
Tympanoplasty – Surgery performed behind the ear drum to examine and fix problems with the ear drum and hearing bones. Patching the perforation by lifting the ear drum. This method is slightly more invasive however has a smaller chance of failure, and is needed for large perforations, and for perforations having a large hearing loss to evaluate the hearing bones that attach to the ear drum.