Voice, Swallowing & Throat Disorders

About Fiberoptic Endoscopic Evaluation of Swallowing

Fiberoptic endoscopic evaluation of swallowing (FEES) is a procedure used to assess swallowing function by real-time visualisation of the throat, voice box and opening of the esophagus. It is performed by the ENT surgeon together with a speech therapist.

FEES may be useful in the assessment of patients who have difficulty swallowing or who are at risk of aspiration (where food or fluid leaks into the lower airways often leading to pneumonia). Examples of situations where FEES is employed include conditions where there is dysfunction of the nerves that control and coordinate swallowing e.g. after motor vehicle accidents, patients with stroke or other neurological conditions.

A fine flexible fibreoptic endoscope is passed through the nose after anesthetizing with topical anaesthesia (spray)  to minimize pain or discomfort. Once the telescope is in position, the patient is given various foods to eat and the swallowing process is carefully observed for safety, efficiency and completeness of swallowing.

The trial foods that a patient swallows may be dyed with methylene blue so that any leakage of fluid or food into the airway (trachea) can be detected.

Beyond assessment and evaluation, the speech therapist can teach a patient techniques to improve swallowing and use real-time observation to give the necessary feedback to the patient.