ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
The possible effect of forceful eye closure and eye opening on nasal valve cross-sectional area during endoscopy.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNasal endoscopy is a routine procedure in the otolaryngology clinic, yet intra-procedural discomfort is common and may deter future examinations. Preliminary observations suggest that eye closure may affect the nasal valve cross-sectional area, which, in turn, has the potential to impact discomfort during endoscopy, as it is the narrowest part of the nasal passageway.
objectiveTo evaluate the effect of forceful eye opening and closure on the nasal valve’s cross-sectional area using rigid video-endoscopy and digital image analysis.
methodsA prospective pilot case series study. Nasal video endoscopy of the right nasal vestibule was performed by a rigid endoscope in 3 facial positions: relaxed, eyes tightly closed, and eyes wide open. Nasal valve images were assessed by two independent, blinded examiners, who quantified the nasal valve cross-sectional area. The area size in the “relaxed” position was used as a reference against which the area sizes in other facial positions were normalized.
resultsThe study included 36 volunteers, of which 27 were females (75%). The mean age was 40.7 ± 12.7 years. The nasal valve cross-sectional area was significantly smaller at the “eyes tightly closed” position, compared with the “relaxed” position (Z = -5.232, p-value < 0.001) and with the “eyes wide open” position (Z = -5.169, p-value < 0.001). No significant difference was found between the “relaxed” and “eyes wide open” positions.
conclusionThis hypothesis-generating pilot study demonstrated that tight eye closure is associated with a significant decrease in the cross-sectional area of the nasal valve. Considering the possible relation between a narrow passage and discomfort, further studies investigating the association between eye closure and patients’ discomfort during endoscopy are encouraged.
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