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:  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 [...]

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 [...]

The History of the Modified Barium Swallow Study

The History of the Modified Barium Swallow Study

No matter what you call it...there is a history behind the Modified Barium Swallow Study (MBSS). Gold Standard? The Modified Barium Swallow Study has long been called THE gold standard in dysphagia evaluation, however it does have its limitations.   The MBSS definitely continues to be A gold standard in swallowing evaluation. Early Days In the [...]