Improvement in Lower Facial Weakness and Swallowing Movements Following Semi-Dynamic Fascia Lata Grafting in Oculopharyngodistal Myopathy: A Case Report

Background: Oculopharyngodistal myopathy (OPDM) is a rare disorder with progressive ptosis, ophthalmoplegia, and oral incompetence, which pose challenges to management. While surgical interventions for blepharoptosis have been reported, addressing concurrent facial muscle weakness remains a significant challenge in comprehensive disease management. Case: A 59-year-old woman with OPDM exhibited severe ptosis and oral incompetence. Despite undergoing prior cosmetic interventions, these symptoms had progressively worsened over 10 years. Preoperative evaluation revealed complete ptosis with a margin reflex distance 1 (MRD-1) of 0 mm and preserved Bell’s phenomenon. A two-stage reconstruction using fascia lata grafting corrected ptosis with a frontalis sling and restored oral competence with U-shaped grafts anchored to the zygomatic arches. Results: At 3 years and 6 months postoperatively, eyelid elevation had improved without corneal exposure, and oral competence was restored, resolving drooling. Conclusions: Semi-dynamic reconstruction using fascia lata grafting effectively addresses ptosis and oral incompetence in OPDM, improving visual and swallowing functions and enhancing quality of life.