Paranasal Sinus Surgery

how much freediving have you done and have you done a course?

If you are thinking of surgery to aid your equalisation, I would not recommend it. I have had sinus surgery last year for medical reasons. My septum was in two pieces and therefore creating a place for bacteria to grow in my nose. I also had an 11mm cyst removed from my frontal sinus. I was constantly full of phlegm and due to the cyst, I had a very hard time equalising. With practice, I was able to Frenzel and managed to dive regularly to 40+meters.
After my surgery, my chronic headaches have been greatly decreased and I now breathe much better, but I feel that my equalisation is the same. I still have a tremendous amount of phlegm in my sinuses. The fact that I had my nose straightened and my forehead sinus cleaned out doesn't change the fact that my body is producing alot of phlegm. If you learn to manage it with diet and some over the counter health remedys, you will be able to equalise as deep as you need to if you do it correctly.
Good luck.

That "double equalisation" you are mentioning is exactly how I used to have to equalise. I would clear my ears, and then forcibly frenzel the air into my forehead. Have you had a CTscan of your face? You might actually have some blockage in your frontal or maxillary sinus that you are having to push through. Before my surgery, My right maxillary sinus was almost 100% blocked and my left frontal sinus,well, had a cyst that would make it very difficult to clear. When I was younger (much younger), I had no troubles equalising. After my injury involving my head, my ability to breathe along with equalising became progressively worse.
If you get the surgery, remember that your body will probably produce an excess of phlegm. I am currently trying to find a way to get rid of this problem for myself. I eat no dairy products, and I am getting acupuncture treatments to try to get my body in balance. I am also making plans to see an allergy specialist which I hear from some people might determine the actual cause of excess mucous.
As far as equalising goes, the first three or four dives for me are effortless to equalize. What I have noticed now is that I end up frenzeling mucous into my eustacian tubes and after several dives, my ears become clogged,not my sinuses. Just a heads up.
If you are not suffering any other health problems (migraine headaches,sinus headaches, tooth infection,sinus infection,etc.) I would suggest trying to find the cause of the mucous/phlegm first. You might be surprised that you don't need surgery. If you get a CTscan and it looks like you got hit in the face by a charging bull,(like mine) than get the surgery the next time you have a few days to rest.
Remember that this is just my opinion and a brief account of what I currently experiencing. I am definitly not an expert at this.Good luck.
Tony
(I forgot to mention the otc remedies that I have tried. I have tried them all.It might be an individual thing.For me, clariton along with mucinex taken every twelve hours starting 48 hours before I dive has helped. The problem now is the weather is so nice, I am diving every couple of days and it seems like I have to stay on it. I went diving Sunday with no preparation beforehand. I took a blast of Afrin, stayed well hydrated, and made a couple dives to 30+meters without much problems. One thing I have noticed with forehead pressure is if I keep my mask fitted loosely and don't let it compress against my face, My forehead would clear much easier)