The Role of the SLP in the Performance & Interpretation of Endoscopic Evaluation of Swallowing: Position Statement. (ASHA website):
Knowledge and Skills for SLPs Performing Endoscopic Assessment of Swallowing Functions (ASHA website):
The History of FEES
Langmore, S.E. History of Fiberoptic Endoscopic Evaluation of Swallowing for Evaluation and Management of Pharyngeal Dysphagia:
Changes over the Years. Dysphagia. (2017) 32: 27.
The Safety of FEES
FEES is extremely safe and well-tolerated when performed by a trained medical SLP. The incidence of complications associated with FEES is less than 1%.
- Aviv, J.E., Kaplan, S.T., Thompson, J.E., Spitzer, J., Diamond, B., & Close, L.G. (2000). The safety of flexible endoscopic evaluation of swallowing with sensory testing (FEEST): An analysis of 500 consecutive evaluations. Dysphagia, 15(1), 39-44.
- Aviv, J.E., Murray, T., Zschommler, A., Cohen, M., & Gartner, C. (2005). Flexible endoscopic evaluation of swallowing with sensory testing: Patient characteristics and analysis of safety in 1,340 consecutive examinations. Annals of Otology, Rhinology & Laryngology. 114, 173-176.
- Cohen, M.A., Setzen, M., Perlman, P.W., Ditkoff, M., Mattucci, K.F., & Guss, J. (2003). The safety of flexible endoscopic evaluation of swallowing with sensory testing in an outpatient otolaryngology setting. The Laryngoscope. 113(1), 21-24.
Benefits of FEES
in sensitivityto pharyngeal residue than a Modified Barium Swallow Study (MBSS)
- No radiation exposure
- No need to transport fragile patients to radiology appointments
- Easily performed on bariatric patients and medically complex patients
- Performed at patient’s bedside, or location of choice, and in patient’s natural eating position
- Appropriate for patients on mechanical ventilation
- Physician’s presence is not required during FEES
- High-quality recorded imaging with same day copies provided
- Allows for observation of secretions and/or aspiration of secretions, especially important for patients with tracheostomies
- Allows for visualization of erythema and edema, relevant for reflux findings
- No ingestion of barium
- Allows for visualization of aspiration after the swallow, which is often missed on
a MBSSbecause the radiologist turns off the fluoroscopy after the patient swallows to minimize exposure to radiation
- No time limit for the FEES, allowing the SLP to trial multiple compensatory strategies
***More Literature Available Upon Request