FEES

FEES stands for Fiberoptic Endoscopic Evaluation of Swallowing.

The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is a procedure used by speech-language pathologists to evaluate the pharyngeal stages of swallowing. The portable study uses a flexible fiberoptic laryngoscope which is passed transnasally to the hypopharynx. The scope hangs above the epiglottis and does not pass between the vocal folds. Patients are seated in a functional feeding position and are offered a variety of food consistencies while the swallow is viewed on a TV monitor. The study is recorded and video prints can be left in the medical chart.

The clinician can clearly view laryngeal and pharyngeal structures. The patient is led through various tasks to evaluate the sensory and motor status. Food and liquid are given to the patient so that swallow ability can be determined.

The primary objectives of the FEES are similar to MBS: to assess the pharyngeal stage of swallowing; to detect aspiration; and to determine the safest and least restrictive diet level for the patient.

The major advantages of the FEES compared to MBS are:

  • Cost effective
  • Portability to bedside
  • No radiation
  • No Barium which is distasteful to the patient
  • Uses actual meal tray items
  • Direct viewing of laryngeal functioning for airway protection
  • Functional - it simulates natural every day eating
  • Quick testing and results
  • Used to train the patient via biofeedback
  • Assesses secretions management before risking aspiration of a feeding trial
  • Better assessment of neurological status (including sensation)
  • More detailed rendering of the anatomy than other methodologies
  • Reliable in detecting aspiration
  • Strong evaluation tool in the establishment of treatment and compensatory strategies

 

Information obtained from the FEES examination includes:

  • Ability to protect and sustain protection of the airway
  • Ability to initiate a prompt swallow
  • Timing and direction of movement of the bolus
  • Ability to clear the bolus during the swallow
  • Presence of pooling and residue of material
  • Sensitivity of the pharyngeal/laryngeal structures
  • The effect of anatomy on the swallow

 

Appropriate postural changes and swallowing maneuvers are attempted to detect problems and enable the examiner to make recommendations regarding optimal interventions to improve the safety and efficiency of the swallow, the advisability of oral feeding, and use of appropriate behavioral strategies that facilitate safe and efficient swallowing. The most critical finding is aspiration, and the literature demonstrates that FEES is able to detect this finding with good sensitivity.

Services

Swallowing Diagnostics, LLC offers both inpatient services and outpatient services.

Inpatient Services
For our inpatient services, we contract with the facility (hospital, rehabilitation center) to bring FEES services right to the patient's bedside. We use licensed speech pathologists to perform FEES testing. To arrange services at your facility, please contact katrina@swallowingdiagnostics.net.Outpatient Services Offered

SDX offers fiberoptic assessment to diagnose oropharyngeal dysphagia (FEES). Clients can also have a FEES in a group home setting.

Recommendations:

  • Treatment
  • Diet modifications
  • Hydration
  • Oral hygiene and dental care
  • Compensatory strategies
  • Oral-motor and swallowing exercises
  • Facilitation techniques

The Swallowing Center at Hebrew Health Care

A valuable program is now being offered by Hebrew Health Care’s Rehabilitation Department and Swallowing Diagnostics, LLC. Together we are providing comprehensive outpatient dysphagia services including the Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and VitalStim™ Therapy, which uses neuron-muscular electrical stimulation to strengthen swallowing musculature. Services are offered at an attractive clinic location at:

Hebrew Health Care
1 Abrahms Boulevard
West Hartford, CT

Staffing Services

SDX provides temporary staffing services to rehab facilities, hospitals, and homecare agencies. We will supply you with one of our skilled licensed, insured, and ASHA certified therapists to meet your speech therapy coverage needs. Our coverage can be arranged on an “as needed” basis, offering the flexibility to cover anything from a vacation or maternity leave to providing speech therapy services to your agency or facility on a daily or weekly basis.

SDX looks forward to helping you provide the most complete care to your patients. Please contact katrina@swallowingdiagnostics.net for more information.