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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of forceful eye opening and closure on the nasal valve\u2019s cross-sectional area using rigid video-endoscopy and digital image analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 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 \u201crelaxed\u201d position was used as a reference against which the area sizes in other facial positions were normalized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 36 volunteers, of which 27 were females (75%). The mean age was 40.7\u2009\u00b1\u200912.7 years. The nasal valve cross-sectional area was significantly smaller at the \u201ceyes tightly closed\u201d position, compared with the \u201crelaxed\u201d position (Z\u2009=\u2009-5.232, p-value\u2009&lt;\u20090.001) and with the \u201ceyes wide open\u201d position (Z\u2009=\u2009-5.169, p-value\u2009&lt;\u20090.001). No significant difference was found between the \u201crelaxed\u201d and \u201ceyes wide open\u201d positions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This 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\u2019 discomfort during endoscopy are encouraged.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10103-4","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T09:51:00Z","timestamp":1773654660000},"page":"3121-3127","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The possible effect of forceful eye closure and eye opening on nasal valve cross-sectional area during endoscopy"],"prefix":"10.1007","volume":"283","author":[{"given":"Alisa","family":"Luria","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2968-1279","authenticated-orcid":false,"given":"Keren","family":"Oren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehuda","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oded","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofer","family":"Gluck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"10103_CR1","doi-asserted-by":"publisher","unstructured":"Fuehner T, Fuge J, Jungen M, Gregson A, ed et al (2016) Topical nasal anesthesia in flexible bronchoscopy \u2013 a cross-over comparison between two devices. 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