This is a typical case of serous otitis media which is the result of a persistent obstruction of the eustachian tube, which prevents air entering the middle ear. The air that is in the middle ear becomes gradually absorbed causing a negative pressure which pulls a clear golden yellow serous transudate into the middle ear. Note the golden yellow colour of the tympanic membrane, and the ability to look through the middle ear and see the Structures of the medial wall of the middle ear clearly. This photograph was taken just prior to the patient performing a Valsalva manoeuvre [auto inflation of the middle ear by forcing air up the Eustachian tube.
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