What is FEES?
Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is a diagnostic procedure used to assess the swallowing mechanism. This involves using a flexible endoscope to visualize the pharynx and larynx during swallowing. It is especially beneficial for patients with
head and neck cancer as these cancers can significantly affect swallowing function.
Why is FEES Important for Cancer Patients?
In patients with cancer, especially those with tumors in the head, neck, or esophagus,
dysphagia (difficulty swallowing) is a common issue. FEES allows healthcare providers to directly observe the swallowing process and identify any abnormalities. This is crucial for developing a targeted
treatment plan and improving the patient's quality of life.
How is the FEES Procedure Performed?
The procedure involves the insertion of a thin, flexible fiberoptic scope through the nose and into the throat. The patient is then asked to swallow different consistencies of food and liquid while the clinician observes the swallowing process on a monitor. The procedure is usually performed by a trained
speech-language pathologist or an otolaryngologist.
What are the Benefits of FEES?
FEES provides a direct, real-time view of the swallowing mechanism, allowing for the detection of issues such as aspiration (food or liquid entering the airway), residue (food remaining in the throat after swallowing), and structural abnormalities. It is a valuable tool for assessing the impact of
radiation therapy or surgical interventions on swallowing.
Are There Any Risks Associated with FEES?
FEES is generally considered safe, but there are some
potential risks including discomfort, gagging, nosebleeds, and in rare cases, laryngospasm (a sudden spasm of the vocal cords). However, these risks are minimal when the procedure is performed by experienced clinicians.
How Does FEES Compare to Other Swallowing Assessments?
FEES is often compared to the Modified Barium Swallow Study (MBSS), which is another common swallowing assessment. While MBSS involves X-ray imaging and the use of barium, FEES provides a direct view without radiation exposure. Each method has its advantages, and the choice between them depends on the individual patient's needs and the specific clinical questions to be answered.
Who Should Undergo FEES?
FEES is recommended for cancer patients who exhibit signs of
swallowing difficulties, such as coughing or choking during meals, unexplained weight loss, or recurrent pneumonia. It is also useful for monitoring changes in swallowing function over time, especially in patients undergoing
chemotherapy or radiation therapy.
What Happens After the FEES Procedure?
After the FEES procedure, the clinician will analyze the findings and discuss them with the patient. Based on the results, a
treatment plan may include exercises to strengthen swallowing muscles, dietary modifications, or further medical interventions. Ongoing monitoring and follow-up assessments may be necessary to track progress and make any needed adjustments to the treatment plan.
