This occurs, by definition, when acute otitis media is present. However, if the infection becomes more severe in the bony structures, it can lead to acute mastoiditis. Sometimes, a collection of pus can occur just outside the dura. This is called an epidural abscess. The sigmoid sinus can become infected, thrombose, and serve as a nidus of infection.
Brain abscesses can also occur due to acute otitis media as can facial nerve paralysis.
The facial nerve paralysis is felt to be due to inflammation around the nerve and generally, this responds to appropriate intravenous antibiotic therapy as well as drainage of the pus, either through a myringotomy or a mastoidectomy. All of these complications of acute otitis media have become extremely rare now that antibiotics are available. However, prior to the 1930's, antibiotics were not available and these were much more common. Some people don't outgrow their eustachian tube dysfunction. They may suffer from chronic negative middle ear pressure.