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Flexible Endoscopic Evaluation of Swallow (FEES)

What is FEES?  Flexible Endoscopic Evaluation of Swallowing. This is a procedure that assesses how well you swallow through the use of a small flexible endoscope.  During the procedure, a certified Speech-Language Pathologist (SLP) passes a thin, flexible instrument through your nose. The SLP views parts of your throat as you swallow different food textures that have food dye in them. The endoscope allows the SLP to see parts of your larynx, pharynx and trachea on a video screen. The procedure usually takes 5-10 minutes and has very minimal risks involved. Research shows the risks associated with endoscopy are mild and extremely rare (less than 1%) with minimal discomfort. The biggest risk is experiencing epistaxis (nose bleed). 


Why would it be needed? A FEES procedure can help assess if you are having any problems with food or liquid passing through your throat and protecting your airway. You may need this test if you have trouble swallowing (dysphagia). With dysphagia, there may be an impairment with the muscular coordination and strength needed for efficient and safe swallowing. Dysphagia can lead to food or fluid going into the airway or lungs (aspiration). This can lead to pneumonia and other problems, so it’s important to promptly identify and treat your dysphagia if you have it. Symptoms of dysphagia include coughing or choking during or after eating or drinking, feeling like food is caught in your throat, a wet gurggly sounding voice, pain while swallowing, difficulty starting a swallow, eyes or nose watering while eating or drinking, food or liquids coming out of the nose, recurring pneumonia or chest congestion after eating, weight loss or dehydration from not being able to eat enough, drooling, and a fear of choking. There are many conditions that might cause dysphagia, such as: head and neck cancer, brain injury, neurological disease (Parkinson's Disease, ALS, etc.), stroke, esophageal impairments, GERD/Reflux, muscular dystrophies, aging swallow, etc.

Normal Larynx

Airway Invasion


Acid Injured Larynx

        (red tissues, swelling)

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