A 28-year-old woman from rural Maharashtra presents with a 6-month history of foul-smelling purulent otorrhea from the left ear. She reports conductive hearing loss and occasional ear pain. Otoscopy reveals a large central perforation of the tympanic membrane with granulation tissue and polyps visible in the external auditory canal. Pure tone audiometry shows air-bone gap of 35 dB. High-resolution CT temporal bone shows erosion of the ossicular chain and sclerotic mastoid bone. What is the most appropriate management for this patient?