Fiberoptic Endoscopic Evaluation of Swallowing (FEES) Clinic

Endoscopic evaluation of swallowing was adapted to swallowing problems associated with the pediatric age group at Cincinnati Children’s in 1993. It is a study requiring the services of both pediatric otolaryngology and speech pathology.

Fiberoptic endoscopic evaluation of swallowing (FEES) is a procedure that allows physicians to assess areas surrounding the voice box and opening of the esophagus, through the use of a small flexible telescope.

The telescope is passed through the nose after anesthetizing this area to minimize pain or discomfort. Once the telescope is in position, your child is given various foods to eat. The specialist observes and evaluates the swallowing process.

We evaluate the developmental aspects of swallowing and the structural aspects of the upper aerodigestive tract to determine the safety of swallowing.

After the procedure, the specialist can give you and your child specific recommendations to improve the safety and efficacy of swallowing.

The endoscopic swallowing study is just one way to assess the safety and integrity of your child’s swallow mechanism. It:

• Clearly defines the anatomy
• Clearly demonstrates the safety of swallowing
• Is extremely useful in patients who will not accept foods  into their mouths
• Is very helpful in patients where questions of aspiration of saliva are being considered
• Is useful as a preoperative evaluation prior to the reconstruction of the airway, to predict which patients will be at risk for aspiration during the postoperative period

Neurosensory Testing

Neurosensory testing can be performed as a sub-test of the endoscopic swallow study. A small puff of air is used to stimulate the voice box, and the airway protection mechanism is evaluated.

This is a painless study that correlates well with aspiration potential in children. It is also useful to follow patients who have had neurologic problems and are undergoing treatment.

Feeding Team

This treatment has been used to help children who:

• Exhibit weight loss and failure to thrive
• Experience frequent gagging or choking episodes associated with feeding
• May be highly selective about the foods they ingest
• Have a history of recurring pneumonia or chronic lung disease. These may be secondary to swallowing disorders

The endoscopic swallow study is one test in a series of examinations that may be necessary to completely characterize the feeding issues associated with a particular child.

To assist in preparing your child for the FEES study, please download this coloring book.