What is FEES and when is it preferred?

• A. Fiberoptic Endoscopic Evaluation of Swallowing; performed at the bedside, particularly when radiation exposure or patient transport is impractical; assesses laryngeal function and pharyngeal residue
• B. A radiographic swallow study performed with contrast
• C. A surgical procedure to augment swallow function
• D. A blood test to evaluate swallowing function

Answer: (A)

FEES is a bedside swallow assessment that uses a small flexible endoscope passed through the nose to directly visualize the larynx and pharynx before, during, and after the swallow. It is preferred when radiation exposure or patient transport is impractical—such as for critically ill, immobile, or non-cooperative patients—because it provides real-time visualization without moving the patient to radiology. FEES allows you to see how well the airway is protected during swallowing, detect penetration or aspiration, and assess pharyngeal residue after the swallow. It can be repeated easily to monitor progress or response to therapy and may be performed with dyed or colored boluses to improve visualization. A limitation to keep in mind is that the view is best for the upper airway and pharynx, and it does not provide the continuous fluoroscopic view of the entire swallowing process through the esophagus like a radiographic swallow study would.