You refer to nasal congestion and snoring which can indicate both chronic rhinitis related to an allergic condition or very enlarged adenoids. Enlarged adenoids would be more likely, especially if she has been experiencing ear infections or middle ear effusion ('glue ears"). She appears to be having episodes of sleep apnea.
Also, enlarged adenoids are often associated with big tonsils, both being lymphoid tissue and usually due to recurrent viral or bacterial infection. Infection with EB virus (glandular fever or infectious mononucleosis) can be a factor and is often not diagnosed in young children because no blood tests are done to check for this.
The dark circles are related primarily to impaired venous drainage from a chronically congested nose and not to lack of sleep.
It is important to check if she has an allergy to environmental factors, which at her age, are likely to be house dust mite or animal dander if a cat or dog is present in the household. A family history of allergic rhinitis, "sinus problems" and asthma are helpful in assessing if she could have an allergic (atopic) predisposition
It is important to note that if she does have allergic rhinitis with enlarged adenoids, then adenoidectomy will not provide complete relief of her upper airways obstruction. She will still require further treatment, probably with a combination of nasal steroid spray, nasal irrigation with saline and even a nasal decongestant spray, which should only be used for a short period.
If she does have an allergy to dust mite, appropriate environmental control measures would need to be undertaken to reduce the level of exposure.
Therefore, she should be assessed by both an ENT surgeon and an allergist.
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