FEES Research

The Greater Sensitivity of FEES for Evaluation of Swalllowing Compared to MBS

Safety of FEES

FEES Scoring of Penetration & Aspiration

Aviv JE, et al. The safety of flexible endosopic evaluation of swallowing with sensory testing (FEESST): an analysis of 500 consecutive evaluations. Dysphagia. 2000;15(1):39-44.

Willging JP. Endoscopic evaluation of swallowing in children. Int J Pediatric Otorhinolaryngjol. 1995; 32(Suppl):S107-8.

Aviv JE, et al. Flexible endoscopic evaluation o f swallowing with sensory testing: patient characteristics and analysis of safety in 1,340 consecutive examinations.  Ann Otol Rhinol Laryngol. 2005;114(3):173-6.

Nacci A, et al. Complications with fiveroptic endoscopic evaluation of swallowing in 2,820 examinations. Folia Phoniatr Logop. 2016;68(1):37-45.

Warnecke T, et al. The safety of fiberoptic endoscopic evalluation of swallowing in acute stroke patients. Stroke. 2009;40(2):482-6.




Rosenbek JC, et al. A penetration-aspiration scale. Dysphagia. 1996;11(2):93-8.

Colodny N. Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallwing (FEES) using the penetration-aspiration scale: a replication study. Dysphagia. 2002;17(4):308-15.

Butler SG, et al Reliability of the penetration aspiration scale with flexible endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol. 2015;124(6):480-3.

Smith CH, et al. Incidence and patient characteristics associated with silent aspiration in the acute care setting. Dysphagia. 1999;14(1):1-7.



Rao N, et al. Gold-standard? Analysis of the videofluoroscopic and fiberopting endoscopic swallow examiinations. Jj Appl Res. 2003; 3:89-96

Kelly AM, et al. Fiberoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin otolaryngology. 2006; 31(5);425-32.

Pisegna JM, Langmore SE. Parameters of instrumental swallowing evaluations: describing a diagnostic dilemma. Dysphagia. 2016; 13(3):462-72.

Kelly AM, Drinnan MJ, Leslie P. Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evalulation of swallowing compare? Laryngoscope. 2007;117(10):1723-7.

FEES Scoring of Residue

Langmore S, et al. A closer look at residue in the post-radiated HNC population, in Dysphagia Research Society annual meeting. Denver;2016

Perlman AL, Grayhack JP, Booth BM. The relationship of vallecular residue to oral involvement, reduced hyoid elevation, and epiglottic functon. J Speech Hear Res.1992;35(4):734-41.

Dejaeger E, et al. Mechanisms involved in postdeglutition retention in the elderly. Dysphagia. 1997;12(2):63-7.

Park WY, et al. Adding endoscopist-directed flexible endoscopic evaluation of swallowing to the videofluoroscopic swallowing study increased the detection rates of penetration, aspiration, and pharyngeal residue. Gut Liver. 2015;9(5):623-8.

and many more....


Use of FEES in Different Patient Populations

FEES Scoring of Airway Closure

Ajemian MS, et al. Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management. Arch Surg. 2001;136(4):434-7.

Skoretz SA, Flowers HL, Martino R. The incidence of dysphagia following endotracheal intubation: a systematic review. Chest. 2010:137(3):665-73

Patterson M, et al. Functional swallowing outcomes in nasopharyngeal cancer treated with IMER at 6 to 42 months post-radiotherapy. Dysphagia. 2014;29(6):663-70.

Bax L, et al. Speech-language pathologist-led fiberoptic endoscopic evaluation of swallowing: functional outcomes for patients after stroke. J Stroke Cerebrovasc Dis. 2014;23(3):e195-200.
Van Daele DJ, et al. Timing of glottic closure during swallowing: a combined electromyographic and endoscopic analysis. Ann Otol Rhinol Laryngol. 2005;114(6):478-87.

Ohmae Y, et al. Timing of glottic closure during normal swallow. Head Neck. 1995;17(5):394-402.