AR with CHR and frequent recurrent sinusitis Hx, NO whole day with mouth breathing for long periods due to turbinate hypertrophy under Nasonex Tx for periods, severe NO with thick nasal discharge in nasopharynx with PND recent 2 weeks, cant blow out, sniff with PND and yell sputum coughout noted, severe frequent throat clearing due to sticky sputum in throat, bil ear fullness with hearing impairment also noted, headache with forehead fullness, cough intermittent, midnight cough awakening due to PND, PE: PND (+), bil maxilla and ethmoid tenderness (+), yellowish thick nasal discharge was suctioned A: acute bacterial sinusitis P: 1. ENT local Tx 2. oral Augmentin for sinusitis, Voren prn for headache