For adolescents with acute migraine, paranasal air suction can lead to immediate pain relief, according to a study published in BCM Neurology.
The aim of this randomized, parallel, double-blind, prospective study was to evaluate the effect of paranasal air suction on pain relief in adolescents with acute migraine. Patients were aged between 16 years and 19 years, met criteria for migraines according to the International Headache Society, and experienced more than 3, but not more than 15 migraine attacks per month. Patients were randomly assigned to either the treatment group receiving paranasal suction or the placebo group receiving placebo suction.
Paranasal suction consisted of 3 rounds of 10 seconds of suction followed by 10 seconds of recovery in each nostril. The placebo treatment followed the same protocol but instead of suction, only a sound occurred. A standard pain rating scale was used to assess migraine severity and suborbital tenderness both before and after treatment, and airflow rate was recorded during treatment. The primary end point was headache relief immediately after treatment.
Of the 50 adolescents included in this study, 29 were men, 21 were women; 27 were in the treatment group, and 23 were in the placebo group. The level of headache relief was significantly higher in the treatment group, with a mean drop of 37 compared with a mean drop of 12 in the placebo group (P <.01). When grouping patients based on the occurrence of auras, there was a mean drop of 10.5 in the treatment group with auras, a mean drop of 4 in the placebo group with auras, a mean drop of 27 in the treatment group without auras, and a mean drop of 8.5 in the placebo group without auras.
The level of suborbital tenderness on both the left and right side was significantly lower in the treatment group, with a mean drop of 36.6 and 37, respectively, compared with a mean drop of 12.5 and 12 in the placebo group (P <.01), respectively. Again, when grouping patients based on the occurrence of auras, patients without auras experienced a higher drop in tenderness after treatment. Nasal airflow rates differed between nostrils in all but 9 patients, and according to Fisher’s exact test, if one nostril had poor flow, the other nostril had normal flow (P =.01).
Limitations of this study include not evaluating long-term effects or potential adverse events, not analyzing neuro- and vasoactive air molecules, and that the device used for suction was large and not suitable for day-to-day living.
The researchers concluded that “60-[seconds] nasal air suction can provide an immediate relief from migraine pain as well as reduce migraine induced suborbital tenderness. A further study is suggested to compare and evaluate the acute effect, efficacy and side effects of nasal air suction using multiple measurements over a prolonged period.”
Bandara SMR, Samita S, Kiridana AM, Ralapanawa DMPUK, Herath HMMTB. Paranasal sinus air suction for immediate pain relief of acute migraine – a randomized, double blind pilot study. BMC Neurol. 2019;19(1):248.