do you have any pets in the house? cat hair makes quick work of heat sinks and fan housings.
not sure how easy it is to dig into a macbook, but i make a bi-annual ritual out of cleaning my laptop. remove the cover, disassemble the fans, blow out the massive chunks of dust with canned air, and clean everything down with diluted alcohol and cotton swabs.
after an hour's work or so, the thing runs cool and quiet for another few months before it gets gummed up again...
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