April 13

20 Reasons to Choose FEES


  1. No need to transport the patient out of the facility or even our of their room. Transportation can be very taxing. Some people are worn out before the swallow study even begins. Add in inclement weather and things get even worse. The fragile patient can also stay with the nurses and care team who knows them best. 
  1. The patient can be tested in the position they are usually in when they are eating and drinking. Some people, despite all encouragement not to, will eat and drink in bed. Often times reclined. With FEES, we can complete the test or portions of the test with the patient in this position to determine if it changes the safety and/or efficiency of the swallow. 
  1. There is no time limit. With MBSS, time is limited because of course we can’t radiate people all day. Because FEES does not use radiation, studies can last as long as needed. 
  1. A FEES examination can be completed quickly. We provide the FEES within 24-48 hours of receiving the order. Patients don’t have to wait for care they need. 
  1. There are few to no directions to follow. The patient is given foods and liquids and allowed to swallow naturally instead of at a cued time. This is perfect for patients with cognitive or language deficits. We also get a better picture of how the patient eats and drinks on their own. 
  1. FEES uses real foods and liquids. Nothing other than food coloring is added to the foods and liquids keeping the taste intact. There is no need to change the taste with barium. The patient’s swallow will not be affected by having to eat something that tastes bad. 
  1. There are no size limitations. FEES can be completed on bariatric patients without difficulty. 
  1. The treating SLP can be present for the FEES. In fact, we prefer it! The treating SLP knows the patient best and will be proving the daily dysphagia therapy. We believe that when the SLP can be present, outcomes are improved. 
  1. A report of the findings is left at the facility before we leave. No more long searches for results. We hand deliver full color reports after detailed interpretation of the study. 
  1. Aspiration can be identified early to reduce the risk for serious pulmonary complications. If you have to wait weeks for a MBSS, your patient may be aspirating the whole time which can contribute to pulmonary complications. 
  1. Get a view before and after the swallow. With FEES, the camera never stops rolling. We are able to see what happens both before and after the swallow. This is not possible with MBSS because of the radiation exposure. 
  1. FEES provides a clear view of the laryngeal and pharyngeal structures. In a recent study, incidental findings of laryngeal pathology were found in 39% of FEES examinations (Pazak et al., 2021). Routine FEES examinations can be beneficial for this reason. 
  1. FEES can provide real-time biofeedback. Using biofeedback is an effective strategy in many cases. Patients have also reported a higher level of understanding of their swallowing problem when they can see what they are doing in real-time. 
  1. Compensatory strategies and interventions can be tested to make sure that the patient is able to perform them accurately. An exercise is only effective when completed in the correct way. Instruction can be provided with real-time feedback. 
  1. FEES offers visualization of secretions and secretion management. Poor secretion management and aspiration of secretions is an indicator for risk of pneumonia. 
  1. FEES allows for visualization of the vocal folds. Unilateral or bilateral vocal fold paralysis can be easily identified. 
  1. We use a protocol for our studies which allows for comparison of serial examinations. Some patients will need more than one swallow study while they are receiving dysphagia therapy. Our test allows for direct comparison to gauge progress and improvement. 
  1. FEES can be used to assess the patient over a meal. This can provide an answer to the question of if the patient fatigues or not, and if they do, what happens. 
  1. A nurse can administer the patient’s actual pills during the examination. Many patients report difficulty swallowing pills. We are able to use the actual pills that they have trouble with to determine what can be done to help the patient swallow them easier. 
  1. FEES is highly sensitive and accurate in determining the safety and efficiency of the patient’s swallow in order to quickly determine what intervention is needed. 

FEES is a great tool for use for the above reasons and more. Reply here and let us know how FEES has positively impacted you and your patients. 



Clinical Focus, Dysphagia, FEES, Mobile FEES, Swallowing

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