In the study population of 91 patients, they found that use of a steroid nasal spray did NOT help...
HOWEVER, after reading the paper, there is a major flaw to how the study was conducted which would significantly affect study outcomes. Mainly, how the nasal spray is used would strongly affect whether it will help or not.
According to the paper, patients were instructed to simply administer "2 metered sprays in each nostril once daily (55 µg per spray)..."
Unfortunately, this type of administration is bound to fail, mainly because using a nasal spray in this manner is inadequate when addressing eustachian tube dysfunction.
First of all, the eustachian tube openings are at 90 degrees to the face, so the steroid nasal spray bottle needs to be directed towards the back of the head and not towards the eye. This needs to be specifically mentioned/demonstrated as it is not intuitive for most patients (and even doctors). The first picture is INCORRECT! The second picture is correct use. Read more here why directionality is important.
In any case, there are other studies that have found steroid nasal sprays to be helpful for eustachian tube dysfunction as listed under references.
Read more about eustachian tube dysfunction here.
Management of Eustachian Tube Dysfunction With Nasal Steroid Spray. Arch Otolaryngol Head Neck Surg. 2011;137(5):449-455. doi:10.1001/archoto.2011.56
The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. Int J Pediatr Otorhinolaryngol. 2006;70(4):639-645.
Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2006 Jul 19;3:CD001935.