The History of FEES

The History of FEES

FEES FEES (Flexible Endoscopic Evaluation of Swallowing) is a procedure to assess the swallow.   Currently, a laryngoscope is passed transnasally (through the nose) and into the upper pharynx to observe the swallow and the swallow structures through a camera.    Picture from:  http://www.mc.vanderbilt.edu First Description FEES was first described in the literature in 1988.   The [...]

Modified Barium Swallow Study: Gold Standard or Old News?

Modified Barium Swallow Study:  Gold Standard or Old News?

The Modified Barium Swallow Study, no matter what name is used, has been considered a gold standard for many years in the assessment of dysphagia.   Recently there has been a lot of debate about whether the MBSS continues to be the gold standard or if FEES (Flexible Endoscopic Evaluation of Swallowing) has taken the place [...]

The Instrumental Guide to Compensatory Strategies and Maneuvers

When completing instrumental assessments, the easiest way to change the swallow is to change the diet consistency. Dr. Jeri Logemann (1993) has suggested using compensatory strategies/maneuvers in the following order: Postural techniques Sensory techniques Maneuvers Diet changes Remember we can often change the swallow through sensory techniques.   Steele and Miller 2010 concluded:  "Boluses of liquids [...]

Barium

Barium

So, you know all about MBSS, right?  You've learned the MBSImP, you know all about consistencies, all about compensatory strategies. What barium should you use? We are often mixing the same barium used in other studies with food and liquid brought in from the kitchen. At one point, there was a recipe available to make [...]

Compensatory Techniques

Compensatory Techniques

Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. While most compensatory [...]

Mobile MBSS

Mobile MBSS

Did you know?  Have you heard? Instrumental assessments come to you!! Now, you can schedule mobile FEES AND mobile MBSS. This cuts down the cost of transport and the various costs of instrumental in the hospital setting. Do you need Mobile MBSS or FEES at your facility?  Chances are, there's one in your area. Do [...]

Do I Really Not Have Access to Instrumental?

Do I Really Not Have Access to Instrumental?

It's the never-ending soapbox.   I know.  There was probably even an eye-roll at seeing this article. All.  The.  Time. Did you get an instrumental?  Well, why not?   You don't know anything without the instrumental. Reason Numero Uno The number one reason, that I've seen for not obtaining an instrumental is no access.   The SLP wants [...]

Laryngeal Palpation

Laryngeal Palpation

  Why Are You Strangling the Patient? Relax.....  You may walk in to observe a Clinical Swallow Evaluation and see an SLP with 3 fingers on a patient's neck as the patient is swallowing. What in the World are they Doing?? It's called laryngeal palpation.   The ring finger goes on the patient's cricoid notch, the [...]