What is fiberoptic endoscopic evaluation of swallowing with sensory testing?

Fiberoptic endoscopic evaluation of swallowing with sensory testing is similar to fiberoptic endoscopic evaluation of swallowing (FEES).

The difference in the two procedures is that  fiberoptic endoscopic evaluation of swallowing with sensory testing uses an endoscope (a small camera with a light) that can provide information on how well the throat is detecting sensations when a foreign body enters.

Usually if food or liquid travels the “wrong way” during a swallow and enters the airway instead of the stomach (called aspiration), the throat will feel it and trigger a cough. If the sensation is damaged and you can’t sense the food or liquid entering your throat, you may not cough to expel it and protect your airway and lungs.

Over time, food and liquid may aspirate down into the lungs, which may result in an infection called aspiration pneumonia.

What happens during the procedure?

You will be awake and seated upright during the procedure. The speech-language pathologist will use a lubricant on an endoscope to pass it smoothly and quickly through your nose and into the upper part of your throat. Parts of your throat (pharynx/ larynx), including your true vocal cords, and the top of your airway (trachea) will be displayed on a video screen.

Sensation of the throat and protection of the airway are evaluated with the special endoscope designed to deliver small puffs of air onto different areas of the throat. The puffs of air should trigger a laryngeal adductor reflex (LAR) or the moving of particular structures in the throat.

What information will it give my speech-language pathologist and doctor?

Fiberoptic endoscopic evaluation of swallowing with sensory testing is ordered if there is concern about whether or not you are feeling sensations in your throat. This test will help your speech-language pathologist and doctor determine if you have adequate sensation in your throat.

Is this procedure painful?

No. Some people experience mild discomfort during the procedure, which may include a feeling of pressure or tightness in the nose or a gagging sensation.

All of the speech-language pathologists at the Duke Swallow Center have experienced the passing of an endoscope firsthand.

How long does it take?

The study usually takes about 20 minutes, but can take longer in some situations. Afterward, the speech-language pathologist will review the results and discuss them with you.

Most times, the study is video recorded so you can watch and learn about the results immediately after the test.

What are the risks involved?

There is less than 1 percent chance that you may experience a mild nosebleed or laryngospasm, which is a sudden brief closure of the airway.

What should my speech-language pathologist know before I have this procedure done?

Your speech-language pathologist should know if you have had any surgery to your neck, throat, or nose. You should also let your speech-language pathologist know if you have a history of frequent nosebleeds, have a history of a sudden closing of the throat (laryngospasm), are on a blood thinner, or have allergies to foods or food dyes.

Where will this be done?

The study can be done in your hospital room if you are an inpatient, or in the outpatient clinic.

Can I drive home afterward?

Yes.

Do I need to prepare for this test?

No.

How will I get the results of this test?

The results of your test will be discussed with you immediately after the test. Additionally, a full report of the test will be given to your doctor. The speech pathologist will work with you and your doctor to determine the best nutrition plan for you based on the results.