Lower motor neuron facial palsy after ventriculoperitoneal shunt surgery

A 40-year-old woman underwent marsupialisation of a symptomatic retrocerebellar cyst. She developed pseudomeningocoele after the procedure. CT of the brain showed hydrocephalus. Therefore, a right-sided ventriculoperitoneal shunt procedure was performed. Unfortunately, the patient developed lower motor neuron-type facial paralysis immediately after the surgery. We localised the site of injury in the distal fallopian canal probably during tunnelling of the subcutaneous tract for passage of the shunt. We discuss the steps to be followed to avoid such mishaps with a brief review of the literature.