In order to get better airflow past the Pi4b board, I re-ran the cable between the pi board and the lcd. I also mounted the fan on the outside of the case. This is mainly so I can tinker with it a little easier. I put an amazon 40mm fan shroud so I won’t accidentally touch the blades. I think it’s running cooler, anecdotally I don’t notice the fan noise as much.
My next thing to try is replacing with a Noctura 40mmx10mm fan.