Abstract
BackgroundMigraine is a primary headache disorder, which cause significant disability in adolescence. This double blind, randomized clinical trial assessed the immediate effects of suction of paranasal sinus air during an acute migraine episode.MethodsA randomized, double blind study was conducted with 56 selected Sri Lankan school children of 16–19 years of age. Participants who met International Headache Society criteria for migraine (with or without aura) were included in the study. Subjects were randomly allocated into 2 groups where one group was subjected to three intermittent 10 sec paranasal air suctions with a ten sec suction free interval between two suctions for each nostril and the other group was subjected to placebo air suction (no paranasal air suction) in similar arrangement. Severity of headache and sub–orbital tenderness before and after suction were recorded using standard pain rating scale.ResultsAfter dropouts, treated and placebo groups consisted of 27 and 23 subjects respectively. The mean headache pain score drop in the treated group was significantly higher compared to that of the control group. Moreover, there was a difference in the treatment response between the types of headache (with or without aura). With respect to tenderness there was a statistically significant drop in the treated group compared to the control. In general, airflow rates in left and right nostrils were different in these subjects. However such difference was not seen in the tenderness on two sides. Nevertheless it was revealed that airflow rate has a slight negative correlation with the tenderness irrespective of the side.ConclusionSixty–second paranasal air suction can provide an immediate pain relief for acute migraine in adolescents. We did not assess pain outcomes beyond 60 s, but the initial responses suggests the need to further study the efficacy of paranasal suction in migraine. A further study is suggested to evaluate the acute effects, efficacy and side effects of paranasal air suction using follow up over a prolong period.Trial registrationSri Lanka Clinical Trials Registry SLCTR/2017/018, 29 Jun 2017. Retrospectively registered.
Highlights
Migraine is a primary headache disorder, which cause significant disability in adolescence
Split and Neuman stated that 28% of the adolescents had migraines with a female predominance [2] and migraine is the most common disabling primary headache disorder that occurs in children
It can be assumed that acute migraine can be relieved by paranasal sinus air suction during an acute migraine attack. This hypothesis has not been tested before and this study was aimed at assessing the immediate effects of nasal and paranasal air suction on pain relief in migraine
Summary
Migraine is a primary headache disorder, which cause significant disability in adolescence. Split and Neuman stated that 28% of the adolescents had migraines with a female predominance [2] and migraine is the most common disabling primary headache disorder that occurs in children. It is a condition characterized by recurring moderate to severe headache which is throbbing in nature that usually lasts from 4 h to 3 days, typically begins on one side of the head but may spread to both sides and is often accompanied with nausea, vomiting and sensitivity to light or sound.
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