Fibreoptic endoscopic evaluation of swallowing (FEES)

You have been given an appointment for a FEES assessment. This is an assessment co-ordinated by the speech and language therapist and run jointly with a second speech and language therapist and/or doctor. This information sheet provides you with some information about the procedure.

Why have I been given an appointment for FEES?

You have been referred to the speech and language therapy department because you have had some difficulties swallowing or have had surgery or other treatment that may affect your swallowing. The speech and language therapists are trained to assess and treat swallowing problems and some throat symptoms. The FEES enables the speech and language therapist or ENT surgeon (when necessary), to examine your swallowing and your throat in detail. It also enables us to try different foods and/or different techniques if appropriate to help you swallow more effectively.

Can I eat before my appointment?

Unless you have been advised otherwise, you can eat and drink as normal before your appointment. If you are currently feeding through a tube, you can take your feeds as normal up until your appointment time.

What happens during the FEES?

The procedure is conducted by two speech and language therapists. In some cases, other surgeons or speech and language therapists may be present. It usually takes 10 to 20 minutes and can be carried out at the bedside or in the clinic.

A small amount of local anaesthetic may be applied to your nose to enable a thin, flexible nasendoscope to be passed with minimum discomfort. A thin, flexible nasendoscope will be placed into one nostril and moved through your nose. When the end of the nasendoscope is positioned just beyond the back of the nose, a clear view of your throat is obtained. You will be able to see your throat (including your vocal cords) on the television monitor if you choose. You may be given some food and liquid to swallow. This is sometimes dyed with a small amount of blue or green food dye to enable a clearer view of your swallowing. Your swallowing will be observed and taped on video to enable analysis at a later time (if necessary).

When will I know the results?

The speech and language therapist will be able to give you some basic information and advice immediately after the procedure. However, detailed results will only be available when a detailed report has been written. The report is written by the speech and language therapist and the surgeon (where necessary) after viewing the videotape. The report will be sent to the speech and language therapist or consultant who referred you to the clinic and a copy will be placed in your medical notes.

Is the procedure safe? Is it uncomfortable?

The procedure is completely safe. At times the passing of the nasendoscope through the nose causes mild to moderate discomfort. This can be reduced by the application of local anaesthetic to the nose prior to the nasendoscope being passed. The anaesthetic also widens the space in the nose, enabling the nasendoscope to be passed more easily. Once the nasendoscope is positioned above the throat, any discomfort usually recedes. This procedure is very unlikely to cause any bruising to the nose or throat.

What happens afterwards?

You can return to the ward or go home immediately after the appointment as there are no side effects from the procedure. If appropriate, a follow-up appointment will be made for you to see the speech and language therapist to discuss the results in more detail and to give you further advice and exercises to make your swallowing easier. You may also have an appointment made for you to attend the outpatient department.

Further information

If you have any questions about the procedure or the clinic, you can either speak to the staff when you attend for the FEES, or you can call the speech and language therapist on 01223 216200 (Monday to Friday).

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one-to-one care is required.