Cant equalize right frontal sinus

[aquaticj10]

Hello,

I am 23yo and have started my OW cert. I've been to 4 OW sessions so far and have had to call it on 3 dives almost immediately after descending to about 3-4 metres due to intense (I'd say 9-10/10) pain in my frontal sinus on the right side just above my eyebrow. The pain feels like someone is stabbing that spot with a knife. For context I've sat at 3-4M for over 5 minutes before trying to descend another metre and the pain becomes unbearable. Upon ascent I can hear/feel crackling in the same location as the pain. Also note that on every dive I've done I haven't had a cold in the weeks prior nor feel congested, general symptoms are sneezing once or twice a day and some post-nasal drip (minimal) from my hayfever.

The one time I was able to complete a dive at max 7M depth, my 2nd dive was ended within a minute due to being unable to descend because of the pain.

I suffer from hayfever and currently take 2 different antihistamines as well as a steroid nasal spray (not a decongestant). I am against taking things like sudafed or "instant-relief" decongestants due to the risks of a reverse squeeze etc.

My ears equalize perfectly and never really have any issue with them.

I am scheduled for an appt with an ENT but have a trip booked in December. Is there any tips/advice I can make use of? Or is it looking likely that I will have to cancel my trip?

Thanks in advance!

 

[chillyinCanada]

Equalize early and often. Equalize at home before you dive, equalize before you dive as you enter the water, equalize early in your descent, again and again.

You probably do know that you should ascend a bit, to try to equalize again, if a problem develops as you descend, rather than hold in place?

 

[rsingler]

Basically, you can't "equalize" a sinus like you can your middle ear. The middle ear is connected to the nasopharynx by a patulous tube that is amenable to intermittent opening by various maneuvers.
A sinus has a permanent opening across a bony divide which may or may not be obstructed by local edema from inflammation or infection (sinusitis), or be blocked by polyps or other tissue.
If you can clear your ears easily but have repeated frontal sinus squeeze, and a trial of decongestant like Afrin or pseudoephedrine allows a pain-free descent, then a course of treatment to clear up sinusitis might be possible. But you should not dive if you can only descend pain free with a decongestant, or if you cannot descend without pain.

What may happen? You may bleed into the sinus from the relative negative pressure (which will stop the pain). This then clots and sets you up for another infection. There are other complications which are outside my area of expertise.
@doctormike

I would not dive any more until you see your ENT. It is possible that this can be resolved in time for you to then get your OW cert and make your trip, but timing may be difficult.

 

[Rob9876]

ENT is the way to go. My 19 year old son has a similar issue. For him, he takes a steroid (I forget which one) about 4 hours before we splash (bit of a pain for morning dives) and takes Afrin before the first dive and Afrin again before each subsequent dive. Hopefully something like that will work for you. Also, your ENT may recommend a quick surgery where they enlarge an air passage in your sinuses -- though a short surgery, believe the recovery time can take a while, so I'd share your trip timeframe with your ENT if discussing surgery.