A child is present with ear infection, with foul smelling discharge. On further exploration, a small perforation is found in the pars flacida of the tympanic membrane. Most appropriate next step in the management would be

Foul-smelling ear discharge with perforation in pars flaccida (not pars tensa) strongly suggests cholesteatoma. Pars flaccida perforations are characteristic of acquired cholesteatoma, which requires tympano-mastoid exploration for complete removal and prevention of complications like mastoid infection, intracranial spread, or hearing loss. Topical antibiotics or IV antibiotics alone would be inadequate. Tympanoplasty without mastoid exploration would miss the disease extension.