Khong GC, et al. - Researchers conducted this prospective observational study to evaluate the association of sinonasal symptoms and quality of life with the size and position of nasal septal perforation (NSP). The study involved 40 adult patients presented with NSP. According to the findings, NSP's most common etiology was iatrogenic. As for NSP-specific symptoms (nasal crusting, epistaxis, and whistling noise during nasal breathing), a statistically significant negative relationship with the size of perforation (A-P diameter) and position of the perforation was found, indicating that such symptoms improved with posterior and larger perforations. Although the scores did not correlate with size and position of NSP, reported Sino-Nasal Outcome Test-22 scores were similar to patients with recalcitrant chronic rhinosinusitis. Typically observed sinonasal symptoms in NSP improved with more posteriorly placed and larger sized perforations. This research gives an insight into the effect of NSP on quality of life and affirms the medical finding that anterior NSP is more symptomatic.