FEES


 * Fiberoptic Endoscopic Evaluation of Swallowing **

(5:h)

A Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assesses the velopharynx, oropharynx, pharynx, larynx, edema, and mucosal abnormality during swallowing of various foods and liquids to evaluate the effect of fatigue, specific directions, and/or compensatory adjustments (Groher & Crary, 2010).

It is also used to assess anatomy and structural movement through tasks such as speaking to assess tongue base retraction (Cicero & Murdoch, 2006). FEES can reliably identify depth of bolus flow, bolus retention, laryngeal penetration, and tracheal aspiration (Donzelli, Brady, Wesling, Craney, 2001).

A gastroenterologist performs the FEES (Bastian, 1991). Care should be taken to use this examination only in settings where medical personnel are available to ensure patient safety. FEES does not expose the patient to radiation so it can be used repeatedly as a biofeedback tool (Groher & Crary, 2010). The endoscopy machine is easily moveable so bedside exams are possible for patients who are immobile.

FEES provides a clearer examination of anatomy and pooled secretions and sensory functions can be assessed through touching the mucosa (Groher & Crary, 2010).

The major drawback is that the oral phase cannot be evaluated so for a patient with oral cavity changes in anatomy or physiology a VFSS may also be required (Cicero & Murdoch, 2006). The view of the passage of the bolus from the oral to the pharyngeal cavity and movement of the structures during the swallow is obstructed because tissue surrounds the end of the endoscopy, causing “white-out.”(Leder, Acton, Lisitano, & Murray, 2007). Preceding a swallow, the premature spillover of any material into the pharynx or larynx can be observed (Perlman & Daele, 1993).

Below is a link to more detailed information by the American Speech-Language-Hearing Association regarding the role of SLT’s in assessment using FEES. These are a useful summary regardless of the country where you are practising. American Speech-Language-Hearing Association. (2005). The Role of the Speech-Language Pathologist in the Performance and Interpretation of Endoscopic Evaluation of Swallowing: Position Statement [Position Statement].

Available from [|ASHA]this has been summarised at the following link:



VFSS