What is FEES and Why is Everyone Talking About it?

While FEES is recognized as a Gold Standard for evaluation of dysphagia worldwide, it may be new to you or your facility. At times, lack of familiarity with FEES has led to underuse of a procedure that has proven to be a valuable tool in the evaluation of many patients with dysphagia, across the life span, and across many healthcare settings.

WHAT IS FEES?

FEES stands for Flexible Endoscopic Evaluation of Swallowing. It is an instrumental assessment of swallowing function, that allows us to directly visualize the patients throat while they are eating and drinking. We can determine the presence of aspiration, pharyngeal residues, and identify deficits to devise a personalized plan of care. FEES involves the passage of a small flexible scope through the nares. It is well tolerated by most patients. However extremely agitated patients are not good candidates. 

FEES is portable and can be completed at bedside. There is no exposure to radiation with FEES. 

WHY FEES IF YOU ALREADY HAVE ACCESS TO VIDEO SWALLOW TESTS?

Both tests are great tools to evaluate patients with suspected pharyngeal dysphagia. You can think of them as you would a CT scan and MRI of the head for the evaluation of a patient with a stroke. Each test has advantages and disadvantages, indications and contraindications. 

For some patients, a video swallow test may not reveal the reason why a patient is showing signs of aspiration at bedside, or may only show us half of what is causing the symptoms. For instance, only FEES can visualize the presence of an infection such as thrush, reflux related changes resulting in “globus” sensation (i.e. something stuck in the throat), reduced mobility of the vocal cords, or the presence of a space occupying lesion affecting the flow of the bolus. 

FEES is also a great option when patients refuse or cannot have barium (i.e. allergy, healing wounds in throat or mouth after surgery, fear of constipation) or don’t want to be exposed to radiation.

HOW WILL I KNOW IF THE PATIENT/RESIDENT NEEDS FEES OR A VIDEO SWALLOW TEST?

The speech therapist in your building is likely to know when each one of these tests is indicated. 

You can also access our FEES vs VFSS guide below, or you can contact us to discuss. 

HOW DOES THE FACILITY BENEFIT FROM HAVING FEES?

• Patients do not leave their room, reducing risk for infection and reducing staff required to transport patient.
• Treating SLP present during exam (They may bill for their therapy session on the same date as well).
• Staff and family may be present during exam for improved patient compliance and staff education on results and precautions. 
• Ability to better suit the needs and preferences of patients and families. 
• Cost savings range from $200 to >$1000 depending on type of service used for video swallow tests. 

Hope this helps you better understand the value of FEES and why we are thrilled to bring this service to facilities in South Florida. We pride ourselves in providing excellent customer service, and compassionate, patient centered care. If there is ever anything we can do to make your experience better, or your patients needs specific accommodations, please don’t hesitate to ask.