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What is FEES?

FEES is an acronym for Flexible Endoscopic Evaluation of Swallowing. This evaluation is completed by a privileged speech pathologist using a flexible endoscope which is passed transnasally to allow viewing of the pharyngeal and laryngeal structures assessing motor and sensory function as the patient completes a series of tasks. The swallowing process is observed and evaluated as the patient is given various food and liquid textures during the exam.

The following is an excerpt from the ASHA document, The Role of the Speech-Language Pathologist in the Performance and Interpretation of Endoscopic Evaluation of Swallowing: Technical Report developed by ASHA Special Interest Division 13, Swallowing and Swallowing Disorders (Dysphagia) Committee on Endoscopic Evaluation of Swallowing:
“FEES is a comprehensive assessment of swallowing. It includes five components:
•    Observation of the anatomy involved in the oropharyngeal stage of swallowing,
•    Observation of the movement and sensation of critical structures within the hypopharynx,
•    Observation of secretions,
•    Direct assessment of swallowing function for food and liquid, and
•    Response to therapeutic maneuvers and interventions to improve the swallow.

The purpose of the procedure is the comprehensive functional evaluation of the oropharyngeal stage of swallowing, leading to recommendations regarding the adequacy of the swallow, the advisability of oral feeding, and the use of appropriate interventions to facilitate safe and efficient swallowing.

ASHA affirms the role of the speech-language pathologist in performing FEES independently to evaluate swallowing function, and distinguishes it from that of physicians, who use endoscopy to assess the integrity of the laryngeal and pharyngeal structures in order to render a medical diagnosis.”