A 49-year-old man with a personal history of multiple paragangliomas. In 2005 he underwent surgery for right jugular paraganglioma by infratemporal approach with good postoperative evolution. In 2014, surgical treatment was decided for a right vagal paraganglioma due to tumour progression, and the paraganglioma was excised laterocervically. Postoperatively, the patient presented right facial paralysis grade II on the House-Brackmann scale, cophosis and paralysis of the right cranial nerves IX, X, XI and XII. In successive check-ups at the clinic, the patient presented dysphagia, dysphonia, and also reported very intense pain in the infra- and preauricular region that appeared with the start of chewing at all meals, and which progressively subsided. It was decided to inject hyaluronic acid into the right vocal cord, botulinum toxin into the right cricopharyngeus muscle and, given the suspicion of PMS, it was decided to inject botulinum toxin into the right parotid region. Five units were infiltrated in 12 points for a total of 60 units. After 15 days the patient noticed a notable improvement in his dysphonia and complete disappearance of the pain.