What is FEES?
Hello, reader! Let’s chat about FEES.
FEES is an acronym for Flexible Endoscopic Evaluation of Swallowing. This a minimally invasive procedure completing using nasal endoscopy to instrumentally assess swallowing anatomy and functioning. It is performed by a trained Speech Language Pathologist.
FEES was developed by Susan Langmore around 1988. She pioneered its development and use. I’ll defer to the FEES Queen’s words describing it!
“FEES is a procedure used to evaluate patients with dysphagia. It is done throughout the US and in all countries that have established programs to evaluate and treat patients with dysphagia. In many countries it has become the most common instrumental procedure because it is easy to implement in multiple clinical settings (inpatient, outpatient, rehab, mobile). FEES also has an advantage over fluoroscopy in that it can easily be taken to bedside, it requires less staffing and infrastructure, the equipment costs less, it does not involve radiation, and there are no time limits on exam length facilitating assessment of natural eating, comprehensive trialing of compensatory maneuvers, and use as a biofeedback tool.
For those who are not familiar with the procedure, using a flexible laryngoscope and camera allows for visualization of the base of tongue, throat and larynx. When the person eats and drinks, the examiner is able to assess whether the swallow is normal or impaired. If impaired, the nature of the problem can be determined. Using dietary, behavioral, and postural interventions, the examiner then attempts to remediate the problem and determine how the patient can eat most safely and effectively.” - Langmore FEES, LLC
I could, and very well may, write another blog post on the differences between Modified Barium Swallow Studies (MBSS/VFSS) and FEES but it is important to state that one does not supersede the other. In fact, they complement each other! The question in determining the most appropriate instrumental assessment for the patient shouldn’t really be MBSS vs FEES. The question should be, “What am I looking for?” If you have a patient with suspected or confirmed esophageal dysphagia or severe oral dysphagia, I would personally lean more towards an MBSS. If the patient in question has suspected pharyngeal dysphagia, secretions, or possible laryngeal pathology, I would be going for a FEES.
More to come on this topic but I am happy to discuss because FEES is MY JAM!
MyLisa Thiels, MS, CCC-SLP
Speech Language Pathologist, Endoscopist, and Orofacial Myofunctional Therapist
Joy Speech and Myofunctional Therapy
