FEES: State of the Science The history of FEES began in 1986 at the VA Medical Center in Ann Arbor. That year, we had a multidisciplinary team that evaluated patients with dysphagia. As part of our education, we learned what tools and procedures each discipline used to assess patients. Otolaryngology used the flexible laryngoscope ... Article
Article  |   December 01, 1998
FEES: State of the Science
Author Notes
Article Information
Swallowing, Dysphagia & Feeding Disorders / FEES
Article   |   December 01, 1998
FEES: State of the Science
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), December 1998, Vol. 7, 8-10. doi:10.1044/sasd7.4.8
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), December 1998, Vol. 7, 8-10. doi:10.1044/sasd7.4.8
The history of FEES began in 1986 at the VA Medical Center in Ann Arbor. That year, we had a multidisciplinary team that evaluated patients with dysphagia. As part of our education, we learned what tools and procedures each discipline used to assess patients. Otolaryngology used the flexible laryngoscope for their examination. I watched Nels Olsen perform an otolaryngology exam. He passed the endoscope transnasally to the hypopharynx (HP), assessed the anatomy, had the patient hold his breath and phonate to assess laryngeal competence, and then he withdrew the endoscope. I asked Nels, “How can you assess swallowing without giving the patient something to eat?” His reply was something like, “Susan, I don't think you can see much during swallowing with an endoscope.” So we tried, and he was right—with a normal person, the bolus was swallowed when it was in the mouth, during the swallow there was a period of white-out, and after the swallow, the HP looked just as it had before the swallow!” I almost conceded, but since that is not my nature, I suggested that we look at someone who had dysphagia. We did, and were astounded at what we saw: spillage of the bolus into the HP before the swallow, sometimes spilling into the larynx and below the vocal folds, residue of bolus after the swallow, build-up of bolus residue over several swallows, and sometimes, aspiration of this residue. We also noticed that many patients were not sensitive to the presence of the endoscope, just as they were not sensitive to the residue or aspiration. It dawned on me that a new tool for evaluating the pharyngeal stage of swallowing was in my hands—a laryngoscope!
First Page Preview
First page PDF preview
First page PDF preview ×
View Large
Become a SIG Affiliate
Pay Per View
Entire SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia) content & archive
24-hour access
This Issue
24-hour access
This Article
24-hour access
We've Changed Our Publication Model...
The 19 individual SIG Perspectives publications have been relaunched as the new, all-in-one Perspectives of the ASHA Special Interest Groups.