Frequently Asked Questions

Are there any complications with FEES?

Of the potential risks, the most prevalent is a mild case of epistaxis, or nosebleed, the majority of which are self-limiting. The rate of complications associated with FEES is LESS THAN 1% overall. For more information about safety, check out our Resources page.

What if I don't think my patient will participate?

If your patient can swallow, then he or she can participate. Remember, we can’t treat what we can’t see, and we can’t assume the patient will not participate. We owe it to our patients to give it a try. Also, we bill a reduced rate if we are unable to pass the scope. So, give us a call and we’ll give it a go. We think you’ll be surprised with our success rate.

What if I don't want to put my patient through that?

Keep in mind, patients with dysphagia are desensitized in comparison to patients with normal swallowing function. They often will not feel the tiny endoscope with the same intensity as a patient with normal swallowing function.  Again, we owe it to our patients to give it a try. Please don’t waste a patient’s time and money by taking a guess at what you think you see or hear during the bedside swallow exam. What would you want for your loved one?

What if I can’t see aspiration during the “white out” phase?

Did you know that only 5% of aspiration occurs during the swallow? Meaning the other 95% we can see beautifully during the FEES procedure. If the patient is in that 5%, we are able to see the green dye below the level of the vocal folds after the completed swallow. This is one reason why we dye the foods/liquids green.

What’s wrong with the bedside swallow exam?

The bedside swallow exam has been proven time and time again to be nothing more than a screen. This research is hard-to-swallow (pardon the pun) for some clinicians and yet is difficult to deny.  Some SLPs will cite their age and experience as qualifiers for relying solely on bedside clinical exams and/or cervical auscultation to assess dysphagia and make appropriate diet recommendations. Unfortunately, unless the SLPs also have x-ray vision, this type of practice leads to a very high error rate with unfortunate consequences of potential harm to a patient. The proof is in the research.

What qualifications are required for a SLP to perform FEES?

It is within the scope of practice for a trained professional Speech-Language Pathologist to perform FEES as outlined in the following resources:

American Speech-Language-Hearing Association. (2008). Use of endoscopy by speech-language pathologists: position statement [Position Statement]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2002). Knowledge and skills for speech-language pathologists performing endoscopic assessment of swallowing functions [Knowledge and Skills]. Available from www.asha.org/policy.

How long will the study take?

The endoscope is generally in place for approximately 10-15 minutes, depending on the complexity of the case. However, keep in mind, there is no time limit as each patient’s assessment needs are different.