A 49-year-old male with a history of multiple paragangliomas.
In 2005 she underwent surgery for right jugular vein paralysis using an infratemporal approach with good postoperative outcome.
In 2014, the decision was made to perform a surgical treatment for a right vagal progression due to tumor progression, performing excision of the paralyzoma via laterocervical approach.
Postoperatively, the patient presented grade II right facial paralysis of House-Brackmann scale, cophosis and paralysis of the right IX, X, XI and XII cranial nerves.
In successive follow-up visits, the patient presents dysphagia, dysphonia, and also refers to a very intense pain in the infra- and preauricular region that appears with the onset of mastication in all meals.
It was decided to inject the right vocal cord with aluronic acid, to inject botulinum toxin into the right pharyngeal muscle and to suspect a PMS the right cricopharyngeal toxin was decided upon in the region.
Five units were identified in 12 units totaling 60 units.
After 15 days, the patient showed marked improvement in dysphonia and complete disappearance of the pain.
