resources

The Role of the SLP in the Performance & Interpretation of Endoscopic Evaluation of Swallowing: Position Statement. (ASHA website):

https://www.asha.org/policy/PS2005-00112/

Knowledge and Skills for SLPs Performing Endoscopic Assessment of Swallowing Functions (ASHA website):

https://www.asha.org/policy/KS2002-00069/

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

Higher in sensitivity to 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 MBSS because 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