Brief paranasal sinus suction quickly reduced the pain associated with migraine, according to a report in BMC Neurology.
Sri Lankan researchers conducted the study in 50 students aged 16 to 19 who all met International Headache Society criteria for migraine with or without aura. All patients reported sub-orbital tenderness on the right side and 98% had tenderness on the left side.
Sinus pressure. Source: Getty
Students were randomized to receive either three 10-second paranasal sinus air suctions with 10-second suction-free intervals between each pair in each nostril delivered by a Compact High Suction Unit SUC81500 or placebo during a single migraine attack. The placebo device had an identical mask, appearance and sound of air suction.
Twenty-seven students received the active treatment; 23 were in the placebo group. The treated group reported more than three times the drop in mean headache pain score and tenderness compared to the control group, 37 points vs 12 points. Patients without aurora experienced a greater reduction in pain and tenderness than those with aura.
Airflow rate somewhat negatively corresponded to sinus tenderness, but the difference in airflow between nostrils was not reflected in differences in tenderness between the sub-orbital sinuses on each side.
The authors suggested that the reduction in pain and tenderness could be explained by removal of causative molecules in paranasal air and that the suction might reduce or prevent excess production of nitric oxide or other air molecules. They also hypothesized, given nearly universal sub-orbital tenderness in this population, that tenderness could be used as a diagnostic tool for migraine. Similarly, the response to air suction could be used to distinguish migraine from sinusitis and other causes of headache.
The researchers assessed pain relief only at the conclusion of the treatment. They found that 60-second paranasal air suction provided immediate pain relief in adolescents with migraine. The researchers did not, however, assess pain outcomes at points following the treatment. Still, they concluded that “the initial responses suggest the need to further study the efficacy of paranasal suction in migraine” to better understand the acute effects, efficacy, and side effects of paranasal air suction over a longer period of time.