Fiberoptic Endoscopic Evaluation of Swallowing

When dysphagia (difficulty swallowing) is suspected, an instrumental assessment is necessary to objectively determine the underlying physiological impairment, severity of dysfunction, safest diet recommendations, and most appropriate rehabilitation plan.

​

Swallowing and Neurological Rehabilitation (SNR) proudly offers state-of-the-art Fiberoptic Endoscopic Evaluation of Swallowing (FEES) procedures in our dedicated endoscopy suite in midtown Tulsa.

​

SNR was founded by Tiffany Turner, M.S., CCC-SLP, BCS-S, who earned Board Certification in Swallowing and Swallowing Disorders, a distinction reflecting advanced expertise in dysphagia management. We collaborate closely with physicians across Oklahoma and surrounding states to provide comprehensive, evidence-based swallowing diagnostics and treatment planning.

​

What Is a FEES?

​

A FEES assessment uses a small, flexible nasal endoscope with a high-resolution digital camera to directly visualize the structures of the throat during swallowing.

The scope is gently passed through the nose to provide a clear view of the pharynx and larynx without interfering with chewing or swallowing. This allows for real-time visualization of:

​

• Airway protection

• Vocal fold movement

• Pharyngeal muscle function

• Residue patterns

• Signs of aspiration (food or liquid entering the airway)

​

During the study, patients are given various food and liquid consistencies (typically tinted with green food coloring to improve visibility) while the clinician evaluates swallowing physiology.

​

Why FEES?

​

FEES and the Modified Barium Swallow Study (MBSS) are both considered gold standards in swallowing assessment. Each has advantages depending on the diagnosis.

​

Unlike MBSS, FEES:

• Involves no radiation exposure

• Allows for extended observation (including fatigue over a meal)

• Provides continuous video recording

• Offers high-resolution, full-color visualization of anatomy

• Enables assessment of secretion management

• Allows direct visualization of vocal fold movement

​

Because the camera records continuously, clinicians can observe events that often occur before or after the swallow, when aspiration is most common, particularly on residue or reflux. These events may be missed during intermittent fluoroscopy used in MBSS to limit radiation exposure.

​

What to Expect During Your Study

​

Our standard FEES protocol includes approximately 12 trials of various consistencies, including liquids, solids, and, when appropriate, a pill simulation. Patients are encouraged to bring specific foods if certain textures are particularly problematic.

​

The procedure is well tolerated and provides immediate diagnostic insight.

​

Beyond Diagnosis

​

FEES allows detailed evaluation of pharyngeal and laryngeal anatomy. If anatomical concerns such as inflammation, lesions, or structural abnormalities are identified, we will coordinate referral to the appropriate specialist (e.g., ENT or gastroenterology).

Following the study, you and your referring physician will receive:

• A comprehensive written report

• Still images of relevant findings

• HIPAA-secure video clips (upon request)

• Clear diet and safety recommendations

• Individualized treatment recommendations

​

Our goal is not simply to identify swallowing impairment, but to develop a targeted rehabilitation plan that reduces aspiration risk, improves efficiency, and restores quality of life.