2.5 Year Old Male enlarged adenoids, mouth breathing, sleep apnea, wakes up from sleep cranky

I have a 2.5 year old buy who was born with lip tie and tongue tie. Both were cut at age 3 days old. He was never able to latch so he was bottle fed pumped breastmilk until 1 year old. He has sounded congested since the day he was born and has mouth breathed day and night since he was born. . I realize now that he probably had silent reflux but I was a first time mom and did not know that congestion could come from that. He was a very happy baby, did not spit up that much and had a great disposition all the time, sleeping well. He still has a sparkly personality and great disposition. However, he is very cranky all the time, everything is NO! When he wakes up in the morning after a full nights sleep, the slightest thing can set him off into a meltdown. He naps 1x per day ~2-2.5 hrs and he can wake up from that screaming and crying. He has been sick with congestion (sometimes clear, sometimes yellow/cloudy) since the day he started school 9 months ago. He has large dark circles under his eyes that I believe is due to his sinuses being so congested. We have been told to remove his adenoids and tonsils (tonsils are enlarged but not THAT big) due to constant sickness as well as mouth breathing and suspected sleep apnea.

boy/girl twins who turn 3 in April. My daughter is fine but my son has issues. They were born at 37 weeks 4 days via scheduled c-section. My son had torticollis as a baby and went through physical therapy to correct neck issues and limited range of motion for neck. He snores at night, mouth breathing, constantly waking up, and ever since starting school he has had chronic ear and sinus infections. Please help!

1. Age: 2 years 8 months old (2 years 11 months to be exact)
2. Sex: male
3. Build up: tall and stocky
4. Complexion: white
5. Country: USA
6. Mind: high energy, cranky, emotional. Naps once a day. Falls asleep quickly, sleeps for 2-2.5 hrs
7. Stool: loose or normal. 1-2 per day
8. Urine: normal
9. Sweat: none
10. Sleep: snoring loudly, heavy breathing with check going in and out, back and stomach sleeper, sleeps with open mouth, moves a lot in sleep, falls asleep quickly and seems to stay asleep (he is in his bed for 12 hours at night and rarely calls for us) but when I have observed him he seems to have disrupted sleep/sleep apnea
11. Appetite: Strong appetite. Like a wide variety of food
12. Thirst: thirsty, drinks a lot of water - often pees through diaper overnight
13. Cravings: sweet
14. Aversion: none
15. Skin problems: Keratosis Pilaris, dots on skin

List out all your PROBLEMS with its since how long, which part is affected, which side, what you feel during complaint etc:in an order(which came first then which came? Specify the year of onset.
- Enlarged adenoids (diagnosed via X-ray, surgery recommended to remove them)
- Snoring and sleeps with open mouth on the back and stomach, moves/tosses while sleeping. Due to enlarged adenoids he has obstructive sleep apnea (OSA)
- Has always slept with mouth open since he was a baby.
- Very cranky and tantrum prone at the slightest thing. Wakes up crying after full night sleep and naps.
a) Worsening factors for each complaint: started school in September 2023 and started getting sick.He has had constant congestion every day since the second week of school. Seems to have sinus infections given the black circles under eyes. Sounds very nasal because of constant congestion.
b)When Its Better – when he has been on nasal steroids and antibiotics he was better for just a few days and then it came back. When he was out of school for approximately 10 days it was meaningfully better.
c) In your opinion, What is the expected cause for your problem? Enlarged adenoids. I would like to avoid removing them. Mouth breathing - once the adenoids shrink and he is able to breath through his nose he should be able to close his mouth

Please let me know thoughts and actions. Thank you