Welcome in H.C.M.
I have gone through your query regarding difficulty in breathing specially during sleeping to your 4 years old child. Her X-Ray shows enlarged adenoids
and tonsils while tympanometry
revails fluid in middle ear.
After analysing your symptoms and co-relating with investigation reports it appears as adenoids of your daughter are blocking the nasopharynx
and hence obstructing the air way and at the same time eustachian tube opening is also get blocked. All these findings are absolute indication for surgery otherwise various cmplications are likely to be developed.