Abstract
Objective: To determine how well fluticasone propionate aqueous nasal spray worked to reduce fluid buildup in the middle ear, a condition known as middle ear effusion.
Methodology: This comparative interventional clinical study involving 70 patients with otitis media with effusion (OME) was conducted in Al-Sader Medical City in Najaf from December 2020 and January 2022. Participants had their parents' medical history and ENT exam. OME signs. These included child hearing loss and school failure. OME Otoscopy verified. Pure-tone audiometry and tympanometry followed. Group A received 100 micrograms/day (50 per nostril) fluticasone propionate aqueous nasal spray (NSS-nasal steroid spray) for 12 weeks. NS drops for B. All patients received four-week follow-up calls. Each appointment included otoscopy and audiology. Normal otoscope, type A tympanogram, and better hearing resolved OME.
Results: Nasal steroids helped 40 (NSS). 35 nasal saline drop (NS) patients were 4–13 years old, averaging 8.2. After 12 weeks, group A patient who used the intranasal steroid spray exhibited a definite subjective hearing improvement, but group B patients who used nasal saline drops did not. 75% of intranasal steroid patients had type A tympanometry curves after three months (p< 0.00001). Group A intra nasal steroid spray decreased PTA from 35 dB to 15 dB. Nasal saline drop patients had 25 dB PTA.
Conclusion: One effective therapy for OME is the use of a steroid nasal spray. It's much safer to use now. Research on its long-term and repeated applications is necessary.

Key words: Medical treatment, otitis media, effusion, fluticasone, nasal spray.