Intranasal air suction approach for Management of Acute Migraine Headache: An International Perspective
Jeyapalan, Jeyaniroshan (2025)
2025
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-2025101726121
https://urn.fi/URN:NBN:fi:amk-2025101726121
Tiivistelmä
Abstract
Background:
Migraine was recognised as a widespread and disabling neurological disorder with substantial comorbidities across neurological, psychiatric, and systemic diseases. Although various theories were suggested, the precise mechanism of pathology remained unclear. The Sinus Hypoxic Nitric Oxide Theory (SHNOT) emphasised that excessive sinus nitric oxide (sNO) generated under hypoxic conditions played a central role in migraine development.
Task and Objectives:
The task was to evaluate the effectiveness and safety of two nasal-based interventions—intranasal drug administration (INDAA) and paranasal air suction approach (PNASA)—in the management of acute migraine. The objectives were to compare their clinical efficacy, assess side-effect profiles, and examine the role of sNO and sCO in migraine pathophysiology.
Implementation Method:
An integrative review method was employed. Literature searches were conducted in PubMed, Google Scholar, and the Cochrane Library. A total of 312 records were identified, with 11 studies meeting the inclusion criteria. Thematic analysis was used to interpret results across randomised controlled trials, meta-analyses, case series, and gas analysis studies.
Results:
Intranasal drug administration, including zolmitriptan, lidocaine, hydroxocobalamin, and oxymetazoline, demonstrated variable efficacy and frequent side effects such as irritation or systemic reactions. By contrast, paranasal air suction studies showed rapid migraine relief within one to two minutes, without adverse effects. Gas analysis confirmed that concentrations of sNO and sCO were threefold higher in migraine patients and were reduced after suction, aligning with SHNOT.
Conclusions:
It was concluded that paranasal air suction represented a safe, cost-effective, and non-invasive intervention for acute migraine. The findings validated SHNOT as a strong explanatory framework and highlighted new directions for future treatment innovations.
Keywords: migraine, nitric oxide, intranasal drug administration, paranasal air suction, SHNOT
Background:
Migraine was recognised as a widespread and disabling neurological disorder with substantial comorbidities across neurological, psychiatric, and systemic diseases. Although various theories were suggested, the precise mechanism of pathology remained unclear. The Sinus Hypoxic Nitric Oxide Theory (SHNOT) emphasised that excessive sinus nitric oxide (sNO) generated under hypoxic conditions played a central role in migraine development.
Task and Objectives:
The task was to evaluate the effectiveness and safety of two nasal-based interventions—intranasal drug administration (INDAA) and paranasal air suction approach (PNASA)—in the management of acute migraine. The objectives were to compare their clinical efficacy, assess side-effect profiles, and examine the role of sNO and sCO in migraine pathophysiology.
Implementation Method:
An integrative review method was employed. Literature searches were conducted in PubMed, Google Scholar, and the Cochrane Library. A total of 312 records were identified, with 11 studies meeting the inclusion criteria. Thematic analysis was used to interpret results across randomised controlled trials, meta-analyses, case series, and gas analysis studies.
Results:
Intranasal drug administration, including zolmitriptan, lidocaine, hydroxocobalamin, and oxymetazoline, demonstrated variable efficacy and frequent side effects such as irritation or systemic reactions. By contrast, paranasal air suction studies showed rapid migraine relief within one to two minutes, without adverse effects. Gas analysis confirmed that concentrations of sNO and sCO were threefold higher in migraine patients and were reduced after suction, aligning with SHNOT.
Conclusions:
It was concluded that paranasal air suction represented a safe, cost-effective, and non-invasive intervention for acute migraine. The findings validated SHNOT as a strong explanatory framework and highlighted new directions for future treatment innovations.
Keywords: migraine, nitric oxide, intranasal drug administration, paranasal air suction, SHNOT