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This document summarizes a double-blind, placebo-controlled randomized trial that explored the use of nasal corticosteroids and autoinflation of the middle ear as treatment for otitis media with effusion. 200 children aged 4-8 with chronic otitis media were randomly assigned to receive either fluticasone propionate nasal spray or a placebo spray for 2 years. Children with odd numbers were also given an autoinflation device to use daily. The primary outcome was treatment failure defined as hearing loss over

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