What is the role of fiberoptic endoscopic examination of swallowing (FEES) in the workup of dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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An FEES is used to evaluate any structural abnormalities in the nasopharynx, laryngopharynx, and hypopharynx and is particularly useful when a VFSS is not feasible (eg, in critically ill patients unable to tolerate any risk of aspiration, patients in intensive care units who cannot be transferred to the fluoroscopy room, or patients who require prompt evaluation). [43]

The FEES uses a transnasal laryngoscope, and swallowing is directly evaluated by using measured quantities of food colored with blue liquid dye. It is a sensitive technique for detecting premature bolus loss, laryngeal penetration, tracheal aspiration, and pharyngeal residue. Because pharyngeal contraction obstructs the lumen, the FEES does not demonstrate the motion of essential food pathway structures or show the food bolus during the swallow.

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