Call: (502) 938-3337


Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is an instrumental evaluation provided by specially trained speech-language pathologists to evaluate swallow function in individuals with dysphagia. In the FEES procedure, a flexible endoscope is introduced transnasally to the patient’s pharynx where the clinician can clearly view laryngeal and pharyngeal structures and their functions. FEES can be completed in the patient’s typical eating position at bedside or in a private treatment room. During the evaluation, the patient is given any type of food or liquid to assess swallow function. A small amount of food coloring is usually added to assist with delineation of tissue, secretions and bolus trials. Upon completion of the FEES we are able to provide recommendations regarding the safest, least restrictive oral diet, appropriate compensations and treatment strategies to improve safety and reduce the risk of aspiration-related illness.



Options for Instrumental Swallow Studies

There are two options for instrumentally evaluating swallow function: videofluoroscopic swallow study (VFSS), also known as a modified barium swallow study (MBS); and fiberoptic endoscopic evaluation of swallowing (FEES). Studies show that FEES is just as accurate and can be more sensitive than VFSS/MBS in detecting penetration, aspiration, and pharyngeal residue. FEES also allows for visualization of laryngeal structures and assessment of secretion management, which cannot be viewed on VFSS/MBS. Further benefits of FEES are outlined below.


On-site Evaluation: no Transportation Costs Transportation Cost: $500 – $1000
Scheduled & Completed Quickly: average 2-3 days from referral Lengthy Scheduling Delays: 7-14 Days
Familiar Setting: patients remain within facility with family & familiar staff present Unfamiliar Setting: patient transported to radiology suite with SLP who is unfamiliar with patient & medical history
Typical Food/Drinks Barium-Coated Foods/Drinks
No Size or Position Restrictions: allows assessment of bariatric &  kyphothic patients Size Restricted to 19” Window: view often limited by poor posture/positioning
No Time Constraints: no radiation exposure; allows assessment of fatigue Limited Evaluation Time: <5 minutes due to radiation exposure
Treating SLP Present: results obtained immediately; increases productivity & treatment time Delayed Results: SLP unable to initiate treatment or implement recommendations promptly

Practical Reasons for FEES

  • Patient is difficult to transport (i.e., ventilator dependence, quadriplegia, medically fragile)
  • Weak patients with poor endurance
  • Patient is obese or kyphotic
  • Barium allergy or intolerance
  • Study can be scheduled quickly
  • In need of a quick reassessment for diet upgrade
  • In need of a quick assessment to determine safest least restrictive diet
  • Anticipate needing additional time to assess the effects of fatigue and compensatory strategies
  • Cost savings

FEES Imagery:

Anatomy of a normal larynx
Normal larynx viewed during a FEES
Larynx with food bolus viewed during a FEES



Speech & Swallowing Specialists, LLC
8401 Shelbyville Rd. Suite 202 | Louisville, KY 40222
Phone: 502.938.FEES (3337) | Fax: 866.936.9371

Speech & Swallowing Specialists, LLC