What is FEES?


Normal larynx as viewed during FEES
Normal larynx as viewed during FEES

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) initially was developed in 1986 by Susan Langmore, Ph.D., and coworkers.  In 1988, the first data demonstrating the effectiveness of this procedure was published, and in 1991 the American Speech Language Hearing Association (ASHA) endorsed it.  FEES is a sensitive, accurate, portable, and safe assessment that provides clinically useful information relative to swallowing anatomy and physiology to determine swallow safety and usefulness of strategies.

Aspiration as viewed during FEES

Aspiration as viewed during FEES

FEES involves passing a flexible endoscope across the floor of the nasal cavity to the back of the throat to allow viewing down upon the pharynx, larynx, upper trachea, and upper esophageal opening.  The patient is then given food and liquid of various consistencies to swallow, allowing the Speech Language Pathologist/trained Endoscopist to evaluate swallow function in color and naturally with no recording time limits.

There are many great movie recordings of the FEES procedure on You Tube.  Check them out!

Fees can be performed on patients with:

  • Isolation Precautions
  • Obesity
  • Medical complexity
  • Pressure Ulcers/Bed Bound
  • Dementia
  • Nasogastric feeding tubes (NG, Corpak, Dobhoff, etc.)
  • Other types of feeding tubes (PEG tube, J tube, IVs, PICC line, etc.)
  • Supplemental oxygen (nasal cannula)
  • Tracheostomy tubes
  • Speaking valves
  • Ventilator dependence