​​​​​​Provider of mobile Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in the Pacific Northwest!







Northwest Mobile FEES

NW Mobile FEES is a subsidiary of Idaho Dysphagia Specialists, PLLC


Literature Comparing Efficacy of Endoscopic and Fluoroscopic Swallow Evaluations: 

  • Bedside clinical swallow exams by SLPs have proven to be under-estimating and over-estimating aspiration; therefore, the use of instrumental swallow evaluations is imperative.

  • Studies show there is a good agreement between MBSS, also known as videofluoroscopic studies, and FEES when examining premature spillage, pharyngeal residue, laryngeal penetration, and tracheal aspiration.

  • FEES has proven to be as sensitive as, or more sensitive than the MBSS relative to standard swallowing parameters.

Crary, M.A., Baron, J.  (1997) Endoscopic and Fluoroscopic Evaluations of Swallowing: Comparison of Observed and Inferred Findings.  Dysphagia, 12(2).

Langmore, S.E., Schatz, K., & Olsen, N.  (1991).  Endoscopic and video fluoroscopic evaluations of swallowing and aspiration.  Annals of Otalgia, Rhinology & Laryngology. 100(8), 678-681.

Mu, C.H., Hsiao, T.Y., Chen, J.C., Chang, Y.C., &Lee, S.Y. (1997).  Evaluation of swallowing safety with fiberoptic endoscope: Comparison with video fluoroscopic technique.  Laryngoscope, 107, 396-401.

Smithard, D.G., O’Neill, P.A., Park, C., et al. (1998) Can bedside assessment reliably exclude aspiration following acute stroke?  Age and Ageing, 27i(2), 99-106.

Literature Supporting Additional Information Obtainable through FEES: 

  • Because the recording of FEES lasts longer than the MBSS, signs of esophageal motility dysfunction as well as aspiration/penetration after the swallow is detected more often than in the MBSS.

  • Through direct visualization of FEES, anatomical variants and tissue/muscle abnormalities are identifiable, allowing for a distinct picture of the true etiology for the dysphagia.


  • FEES has proven to be a good assessment of saliva management, which is a high risk factor for pneumonia.

Aviv, J.E. (2000). Prospective, randomized outcome study of endoscopy vs. modified barium swallow in patients with dysphagia. Laryngoscope, 100, 563-574.

Kelly, A.M. (2007). Assessing penetration and aspiration: How do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare?  The Laryngoscope, 117, 1732-1727.

Takahashi, N, Kikutani, T, Tamura, F., Groher, M., & Kuboki, T. (2012). Videoendoscopic assessment of swallowing function to predict the future incidence of pneumonia of the elderly. Journal of Oral Rehabilitation, 39; 429-437.

Literature Examining Safety of FEES:

Of the potential risks associated with endoscopy including gagging, epistaxis, laryngospasm, and vasovagal response; a mild case of epistaxis is the most prevalent.

FEES has proven to be a safe and well tolerated method of assessing swallow function when performed by a trained Speech Language Pathologist

Through Susan Langmore’s literature search on the safety of FEES, she concludes the rate of complications associated with FEES is less than 1% overall.


Aviv, J.E., Kaplan, S.T., Thompson, J.E., Spitzer, J., Diamond, B., Close, L.G.  The safety of flexible endoscopic evaluation of swallowing with sensory testing: an analysis of 500 consecutive evaluations.  Dysphagia.  2000;15:39-44.

Aviv, J.E., Murray, T., Zschommler, A., Cohen, M., Gartner, C.  Flexible endoscopic evaluation of swallowing with sensory testing: patient characteristics and analysis of safety in 1340 consecutive examinations.  Annals of Otology, Rhinology & Laryngology. 2005;114:173-176.

Cohen, M.A., Setzen, M., Perlman, P.W., Ditkoff, M., Mattucci, K.F., Guss, J.  The safety of flexible endoscopic evaluation of swallowing with sensory testing in an outpatient otolaryngology setting.  Laryngoscope.  2003;113:21-24.

Warnecke, T., Teismann, I., Oslenber, S., Hamacher, C., Ringelstein, E.B., Schabitz, W.R., & Dziewas, R. (2009).  The safety of fiberoptic endoscopic evaluation of swallowing in acute stroke patients.  Retrieved July 18, 2009 from www.stroke.ahajournals.org.