FEES is completed using a thin flexible fiberoptic endoscope and is performed by a specially trained speech language pathologist wherever the patient is comfortable. The scope is passed along the floor of the nasal cavity into the back of the throat in order to view the larynx and the surrounding structures. Colored foods and liquids are administered, and the patient’s swallow function is viewed from high in the throat.
During the FEES exam the facility’s SLP is encouraged to participate. As the patient eats, specific swallowing deficits can be identified and compensatory strategies and maneuvers can be completed in order to develop the most effective treatment plans to improve the patient’s swallow function and overall quality of life.
Each examination takes approximately 10-15 minutes depending on how each patient presents. Unlike VFSS, FEES has no time restriction and there is no exposure to radiation so if a patient requires additional time or trials we can accommodate any individual’s needs.
When is FEES preferred over MBSS?
Need to assess swallowing ability and fatigue over the course of a meal. MBSS have restricted time limits due to radiation exposure
Completing a therapeutic examination in which different maneuvers and consistencies need to be trialed to determine safest way to tolerate the least restrictive diet. We can use biofeedback to aid patient in completing maneuvers during the evaluation.
When positioning for MBSS is problematic (patient wearing a neck-halo, on ventilator, severe weakness, or bedridden). We can scope a patient anywhere!
To visualize the larynx for signs of trauma or neurological damage especially post surgery, intubation, coronary artery bypass grafting, carotid endarterectomy, and tracheostomy placement. Unlike MBSS, with FEES we can see damage to laryngeal tissue, edema, damage to the vocal folds and presence of secretions.
To assess severe dysphagia in an individual who may have very low ability to tolerate any aspiration. We can assess patients with poor pulmonary status, patients who are immunocompromised, and individuals who have suspected absent swallow. Unlike an MBSS we don't use barium and can trial ice chips and view patients swallow and ability to tolerate secretions without oral intake."