Flexible Endoscopic Evaluation of Swallowing
Speak and Swallow are proud to offer a Flexible Endoscopic Evaluation of Swallowing (FEES) service to adults and adolescents from the convenience and comfort of a private clinic space in Burpengary East, Brisbane. This service is provided by experienced and suitably trained Speech Pathologists with an advanced scope of practice, under the guidance and care of medical professionals.
Speak and Swallow are proud to offer a Flexible Endoscopic Evaluation of Swallowing (FEES) service to adults and adolescents from the convenience and comfort of a private clinic space in Burpengary East, Brisbane. This service is provided by experienced and suitably trained Speech Pathologists with an advanced scope of practice, under the guidance and care of medical professionals.
The FEES clinic service will provide holistic care to clients with swallowing difficulties at Speak and Swallow by complementing clinical swallow assessment with gold-standard, evidence-based instrumental assessment. Clinical swallow assessment will be completed prior to instrumental assessment (this may be completed by Speak and Swallow staff, or by an external clinician).
The Purpose of Flexible Endoscopic Evaluation of Swallowing:
• Evaluate the functional impact of normal and abnormal anatomy and physiology on swallowing
• Discriminate between normal and abnormal swallowing function
• Directly visualise naso/oro and laryngopharyngeal structures, mucosa, secretions, sensory response, and pharyngeal swallow function
• Grossly assess sensation
• Assess and characterise dysphagia
• Identify and/or hypothesis factors contributing to pathophysiology
• Identify aspiration of food and drink during swallowing
• Directly view the bolus and residue within the hypopharynx
• Make observations of swallowing function over an extended period of time
• Evaluate the integrity of laryngeal function and airway protection as it relates to swallowing function
• Enable a clearer understanding of dysphagia aetiology, severity, and prognosis, thereby guiding dysphagia treatment
• Identify and evaluate the effectiveness of interventions, and support biofeedback during intervention
• Provide education to clients and carers
Signs and Symptoms that may indicate suitability
for FEES
- History of swallowing difficulties (dysphagia)
- Coughing and choking when eating and drinking
- Difficulty managing oral secretions (saliva)
- Difficulties initiating a swallow
- Gurgly or wet voice quality after eating and/or drinking
- Difficulty coordinating swallowing and breathing
- Abnormal voice quality and suspected swallowing difficulties
- Pain when swallowing (odynophagia)
- Fatigue during swallowing
- A sensation of food or drink getting stuck in the throat (globus pharyngeus)
- Regurgitation of foods or liquids
What to Expect from Flexible Endoscopic Evaluation of Swallowing:
During a FEES procedure, a small tube, called a nasendoscope is placed in one nostril and directed to the back of your throat. You will then be asked to try a range of foods and drinks to see which is easiest and safest for you to swallow. These may be coloured with white, green, or blue food dye to provide a clear contrast on images. This procedure takes approximately 20 minutes to complete.
This procedure is extremely safe and generally there are no complications. However, to ensure your safety, Speak and Swallow are supported by The Hub Medical Centre – located in the same precinct – to provide medical support if required during or after your Flexible Endoscopic Evaluation of Swallowing.
After your procedure, your Speech Pathologist will discuss your results and develop a management plan for you. This may involve a formal examination and diagnosis by a Respiratory Physician and/or an Ear Nose and Throat Specialist. Speak and Swallow often work alongside Dr Elizabeth Hodge, based in Brisbane, and Dr Paul Paddle and Dr Anthony Rotman from Melbourne Swallow Analysis Centre to assist this process.
Flexible Endoscopic Evaluation of Swallowing procedures at Speak and Swallow will take place in a purpose-built clinic area, meeting infection control standards and fitted with specialised equipment. Speak and Swallow use EndoCOMPACT Veezar by XION, which is TGA approved and trusted by both ENTs and Speech Pathologists globally.
Speak and Swallow’s FEES service will not replace clinical swallow assessment performed by Speech Pathologists. Similarly, it will not replace diagnostic upper aerodigestive tract examinations performed by medical professionals.
Contraindications:
Contraindications for Flexible Endoscopic Evaluation of Swallowing procedures may include but are not limited to:
- Severe agitation and reduced ability to cooperate
- History of vasovagal or fainting episodes
- Nasal trauma
- Recent treatment for head and neck cancer (including surgery, chemotherapy, and radiotherapy)
- Obstruction of both nasal passages
- Severe movement disorder
- History of severe epistaxis
- Where poor mucosal condition is suspected and nasendoscope insertion may cause further trauma
- Currently taking anticoagulation medication
- Base of skulls / facial fracture
- Unstable cardiac conditions
- Nasopharyngeal stenosis
- Sino-nasal anterior skull base surgery / tumours
Risks:
There are some known risks in the provision of FEES procedures. Speak and Swallow acknowledges these risks and has risk assessment processes in place to mitigate potential risks to client safety.
- Epistaxis (nose bleeding) Reported to occur in up to 1.2% of assessments.
- Laryngospasm (spasms of vocal folds which impact breathing) Reported to occur in up to 0.07% of assessments.
- Syncope collapse (including fainting, vasovagal syncope) Reported to occur in up to 0.1% of assessments.
- Person-to-person and environmental contamination
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