Blog Post
What Is a Fees and Why Would You Need One??
7/12/2024
What is FEES?
FEES is an instrumental swallowing assessment that lets us see inside your throat while you're eating and drinking. The technical name for the assessment is Fiberoptic Endoscopic Evaluation of Swallowing.
FEES is a gold standard in diagnostic swallowing assessments. This means a significant amount of research shows that this assessment is highly reliable and effective in assessing swallow function and aspiration risk.
This test uses an endoscope with a very thin, flexible scope, a tiny camera, and a light on the end. I start by passing the scope, which is only 3.2 mm, along the floor of your nose, past your soft palate, until the camera sits just below the uvula—the hanging part in the back of your mouth. I will then look at different parts of your throat while you swallow different foods and drinks.
Why might you need a FEES evaluation?
A FEES may be recommended for several reasons; however, the most common is when someone has swallowing difficulties. If you have difficulty swallowing, you may be at risk for food, medications, liquids, or saliva entering your lungs. If this happens, it can lead to an infection in your lungs known as aspiration pneumonia. You may also be at risk of not eating and drinking enough to maintain your overall nutrition. This could lead to dehydration or malnutrition as well as lower general well-being.
An instrumental assessment, such as a FEES, helps your care team know what is happening inside your throat and if you are at an increased risk of aspirating, acquiring an infection, choking, or if the structures above your esophagus are working just as they should. I believe in seeing and understanding the problem to treat it effectively. The information gathered from a FEES assessment is used to develop a personalized treatment plan to improve your swallowing function, reduce your risk of aspiration, and enhance your overall health and well-being. This personalized approach ensures that your unique needs and circumstances are considered.
FEES is one of two gold-standard tests for instrumental swallowing evaluations – FEES and Modified Barium Swallow Study (MBSS). These types of tests are highly beneficial to you and your care team. They allow us to see how you swallow by looking inside your body instead of relying on only your symptoms and what we can see from the outside. These tests allow SLPs to see the structures inside your throat and how they work together when you swallow. I can then use this information to discuss your swallowing function, make informed recommendations, and work with you to help you improve your strength and safety.
While each of these gold-standard assessments are highly beneficial, they approach the assessment differently and show information differently. With a FEES using the Patcom Distal Chip Endoscope, you will see a full-color picture with a clear and continuous visualization of the inside of your throat, including the back of your tongue, the epiglottis (fancy name for the flap of cartilage in your throat that flips down before you swallow), your vocal cords, and all the little nooks and crannies around them. With a FEES, the recording doesn't stop as it does with a Modified Barium Swallow Study (MBSS). Due to the use of radiation to see the barium-coated foods someone eats, MBSS assessments can miss several vital factors. These may include events before or following the swallow, or they may end up missing the swallow altogether if someone needs too much extra time, as radiation time needs to be kept as low as possible. With a FEES assessment, there is no additional radiation, no ingestion of barium, and no trip to the hospital to have all of this done. Instead, you can enjoy my comfortable office with familiar foods and soothing music. As a bonus, a FEES assessment can be repeated as often as needed, used during an entire meal, and even used during treatment as biofeedback.