AR (Dp; 4+) with CHR Hx, nasal obstruction whole day with mouth breathing and poor sleep for long periods due to turbinate hypertrophy, sniff, few sneezing, few rhinorrhea, few blownose, s/p xyzal 1# hs other clinic Dr given 108/9 till now but still nasal stuffiness, PE: severe swollen hypertrophic turbinates# Severity classification: >4 days a week and >4 weeks Abnormal sleep due to N-O troublesome symptomsA: Moderate-severe persistent AR and CHRP: 1. daily controlling drugs with Nasonex 2. may refer to ENT for Laser turbinoplasty if no improve after Nasonex