Table 1.

Description of the manual techniques used for the experimental group

Manual techniques	Description
Frontal sinus drainage technique	With the thumbs placed just lateral to the midline of the forehead, apply gradual raised and released pressure down to the sinuses in a smooth rhythmic motion within the patient’s acceptable pain level, and repeat 7 times. The center of the forehead is then positioned with the thumbs put side by side, and a sweeping motion from the center of the forehead and traveling inferiorly while remaining in front of the ears is used to help drain the frontal sinuses, which is performed 7 times [15].
Nasal passages drainage technique	The therapist positioned the patient’s nose with the left thumb on the right side and the right thumb on the left side, the thumbs crossing above the bridge of the nose. Each thumb alternatively exerted pressure while moving down the nasal bone’s length seven times, then uncrossing the thumbs allowed for a bilateral sweeping motion that was repeated 7 times along the sides of the nose and out across the maxillae [16].
Maxillary sinus drainage technique	The therapist used the thumb to provide gradual increasing and released pressure down to the maxillary sinuses in a smooth rhythmic motion within the patient’s tolerable pain level, repeating 7 times. Then, drain the maxillary sinuses seven times with a sweeping motion from the maxillary sinuses down to just below the ears [17].
Self-sinus massaging technique	For the frontal sinus: The patient put his or her middle and index fingers just above the eyebrows on either side of the forehead, and performs gentle circular outward massaging for three sets of 30 seconds, repeated twice a day [20].
	For the maxillary sinus: On either side of the nose, the patient placed his or her middle and index fingers in the space between the cheekbones and the upper jaw, perform gentle circular outward massaging for three sets of 30 seconds, repeated twice a day [21].