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Fiberoptic Endoscopic Evaluation of the Swallow (FEES)

What is FEES?

Fiberoptic Endoscopic Evaluation of the swallow (FEES) is a well-established technique that has revolutionized the field of dysphagia diagnostics. FEES is a sensitive, accurate, portable, and safe examination that yields clinically useful information relative to swallowing physiology and swallowing safety. The procedure involves passing a flexible endoscope across the floor of a patient’s nasal passage into the pharynx so that the larynx, pharynx and upper esophageal opening are viewed directly from above. Then the patient is administered food or liquids mixed with food coloring in order to determine safe swallowing function and integrity. FEES can be done at the bedside, in an office, intensive care unit or in a long-term facility in under 20 minutes with regular food and liquids. Since there is absolutely no radiation administered the studies are able to be sustained for longer time intervals, allowing the clinicians the ability to tell if a patient’s swallowing technique is impacted by fatigue.

How does FEES compare to the Modified Barium Swallow Study(MBSS)?

  • Cancer Screener

  • Vocal Pathology Screener

  • No need to coordinate time with the radiology department for scheduling

  • No radiation exposure with FEES

  • No unpleasant barium-tainted food and no barium-associated constipation for patients

  • No waiting to be cleared from isolation precautions

  • FEES can be used with patients on mechanical ventilation and tracheostomized patients

  • Normal food is given to patients

  • FEES can be performed while a patient is sitting upright or in bed

  • FEES can be performed easily on morbidly obese patients as opposed to the MBS where a C-ARM would have to be used for fluoro.

  • FEES can be given to medically complex patients who otherwise would not tolerate the transfer to the radiology suite

  • The physician does not have to be present during a FEES exam

  • FEES is shown in High Definition digital color as both a still and a video

  • The use of the term “gold standard” as previously applied to the MBSS is no longer the case

  • Minimal to no complications

  • Instant result

  • Used for biofeedback for voice and swallow

  • Videotape recording of endoscopies objectively discover and document details that cannot be appreciated by the unaided eye in real-time

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