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Not having case fans is the biggest nono I can think of in aircooling circles.
Two quiet 80mm fans in a push/pull (one intake, one output) will cost you no more than a tenner and will drop case temperatures by a huge amount.
If you've been running without fans for a while you may want to check your CPU cooler is still functioning properly. Applying a new layer of paste will help teh CPU temps plus a couple of large casing fans as sugested above will push more air around the card. You could get a slot fan and site it close to the GFX card but I don't think they are silent.