Position Statement: Fiberoptic/Flexible Endoscopic Examinations of Swallowing (FEES)

Fiberoptic endoscopic examination of swallowing (FEES) is a well-established diagnostic procedure medically indicated for diagnosis, treatment planning, and monitoring of oropharyngeal dysphagia.^1-5  FEES is able to be readily performed in inpatient, outpatient or long-term care settings.  FEES is safe, validated, and widely performed both in adults and children, and is not considered investigational^6,7,8.  FEES is a separate procedure and it is not considered part of a routine evaluation and management office visit.

CITATIONS

1. Langmore, S. E., Schatz, K. & Olsen, N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 2, 216–9 (1988).
2. Hafner, G., Neuhuber, A., Hirtenfelder, S., Schmedler, B. & Eckel, H. E. Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Eur. Arch. Oto-Rhino-Laryngology 265, 441–446 (2008).
3. Langmore, S. E. Endoscopic evaluation of oral and pharyngeal phases of swallowing : GI Motility online. GI Motility online (2006).
4. Leder, S. B. & Murray, J. T. Fiberoptic Endoscopic Evaluation of Swallowing. Phys. Med. Rehabil. Clin. N. Am. 19, 787–801 (2008).
5. Pisegna, J. M. & Murray, J. Clinical Application of Flexible Endoscopic Evaluation of Swallowing in Stroke. Semin. Speech Lang. 39, 3–14 (2018).
6. Andrea Nacci, Federica Simoni, Rebecca Pagani, Amelia Santoro, Silvia Capobianco, Clelia D’Anna, Stefano Berrettini, Bruno Fattori, Luca Bastiani. Complications during Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in 5680 examinations. Folia Phoniatr Logop. 2022.
7. Claire Kane Miller, Jay Paul Willging. Fiberoptic Endoscopic Evaluation of Swallowing in Infants and Children: Protocol, Safety, and Clinical Efficacy: 25 Years of Experience. Ann Otol Rhinol Laryngol. 2020 May;129(5):469-481.
8. Luis Fernando Giraldo-Cadavid, Lorena Renata Leal-Leaño, Guillermo Alfredo Leon-Basantes, Alirio Rodrigo Bastidas, Rafael Garcia, Sergio Ovalle, Jorge E Abondano-Garavito. Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia. Laryngoscope. 2017 Sep;127(9):2002-2010.