Oral Mucosal Grafting for Nasal Septal Perforation Repair

This study will assess how often a hole in the nasal septum (the wall separating the two sides of the nose), closes completely after surgical repair using tissue taken from the lining of the patient's own mouth. The study will include 46 adults with nasal septal perforations measuring 1.5 cm or less at three hospitals in Spain. Surgery will be performed as part of usual clinical care. Participants will be assessed before surgery and at 1, 3, 6, and 12 months after surgery. The main outcome is complete closure of the perforation at 12 months, assessed by examining the inside of the nose with a small camera. Researchers will also assess nasal symptoms, quality of life, pain in the nose and mouth, and complications. Swab samples will be collected from the nose and mouth before surgery and from the nose during follow-up. These samples will help researchers study changes in the bacteria present in the nose and whether bacteria found in the mouth before surgery are detected in the nose after repair. Researchers will also explore whether outcomes differ according to whether the tissue graft was immersed in chlorhexidine, an antiseptic, during surgery. This decision is made by the surgeon as part of usual care, independently of study participation. The study does not assign participants to treatments.

Inclusion Criteria: * Age 18 years or older. * Nasal septal perforation measuring 1.5 cm or less. * No previous surgical attempt to repair the septal perforation. * Clinical indication for surgical closure of the septal perforation. * Perforation of iatrogenic, idiopathic, traumatic, or controlled inflammatory origin. * Willingness to participate and provision of written informed consent. Exclusion Criteria: * Recent intranasal exposure to toxic substances (less than 1 year). * Active systemic autoimmune or connective tissue disease with nasal involvement. * Active infection involving the nose. * Active periodontal disease. * Previous surgical repair of the septal perforation.