What Is FEESST®?
Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST®) is the state of the art non-radioactive alternative to the Modified Barium Swallow (MBS). This exam will allow for direct assessment of the swallowing mechanisms in order to precisely guide the dietary and behavioral management of patients with swallowing disorders and decrease the risk of complications such as aspiration pneumonia. FEESST® is an office procedure that combines endoscopic visualization of swallowing function with objective assessment of laryngopharyngeal sensory discrimination. The FEESST® procedure directly assesses airway protection by endoscopically administering discrete pulses of air to the larynx in order to stimulate the vocal cords (cause them to close in response to the air pulses). Motor function is assessed by examining the strength of the muscles in the pharynx as they contract during phonation (speech production). Various consistencies of food and liquid (mixed with green food coloring for contrast) are administered with the flexible endoscope in place. The quality of the oral and pharyngeal swallow, along with evidence of airway penetration and aspiration, can be evaluated. FEESST® also allows evaluation of extra-esophageal symptoms of gastro-esophageal reflux (acid reflux) including asthma, hoarseness and laryngitis.
Who is a candidate for FEESST®?
How is FEESST® performed?
FEESST® is a safe, well-tolerated procedure with an extremely low incidence of side effects. A nose bleed is a potential rare but adverse reaction (incidence of 1.1% according to recent research).
The physician passes a thin flexible fiberoptic telescope through the nose into the throat. The first part of the test assesses sensation in the larynx in order to elicit an airway protective reflex. Pulses of air are directed at points on the larynx and the reaction to this stimulus is observed through the endoscopic camera.
The second part of FEESST® entails observing how and where the food travels down the patient's throat during swallowing through an endoscopic camera with a real-time, magnified view. The food is prepared with green food coloring in order to facilitate visibility. The patient is instructed to make certain physical maneuvers, including tucking the chin or turning the head, to find the least restrictive method of travel for the food as it passes through the throat and into the stomach. The speech-language pathologist is very careful to alter the volume and thickness of the food so that patients do not have any choking sensation during the exam.
The procedure takes about ten minutes and is covered by private medical insurance and Medicare.
Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST®) is the state of the art non-radioactive alternative to the Modified Barium Swallow (MBS). This exam will allow for direct assessment of the swallowing mechanisms in order to precisely guide the dietary and behavioral management of patients with swallowing disorders and decrease the risk of complications such as aspiration pneumonia. FEESST® is an office procedure that combines endoscopic visualization of swallowing function with objective assessment of laryngopharyngeal sensory discrimination. The FEESST® procedure directly assesses airway protection by endoscopically administering discrete pulses of air to the larynx in order to stimulate the vocal cords (cause them to close in response to the air pulses). Motor function is assessed by examining the strength of the muscles in the pharynx as they contract during phonation (speech production). Various consistencies of food and liquid (mixed with green food coloring for contrast) are administered with the flexible endoscope in place. The quality of the oral and pharyngeal swallow, along with evidence of airway penetration and aspiration, can be evaluated. FEESST® also allows evaluation of extra-esophageal symptoms of gastro-esophageal reflux (acid reflux) including asthma, hoarseness and laryngitis.
Who is a candidate for FEESST®?
- Patients who complain of trouble swallowing liquid, food or medications.
- Patients who report a lump-like sensation in their throat or pain upon swallowing.
- Stroke patients who experience difficulty swallowing, throat clearing, or choking during meals.
- Patients with a history of reflux.
- Patients with a history of upper respiratory infections, unexplained fevers, or aspiration pneumonia.
- Patients with a history of swallowing difficulty related to an underlying diagnosis of Parkinson's Disease, CP, Multiple Sclerosis, ALS or dementia.
- Patients who receive nutrition via G-tube or NGT with suspected improved function or ability to tolerate oral feedings.
- Patients with a tracheotomy who might be able to tolerate oral feedings or a diet upgrade.
- Patients who are on a ventilator
- Patients concerned with excessive radiation exposure
- Patients who could benefit from biofeedback
How is FEESST® performed?
FEESST® is a safe, well-tolerated procedure with an extremely low incidence of side effects. A nose bleed is a potential rare but adverse reaction (incidence of 1.1% according to recent research).
The physician passes a thin flexible fiberoptic telescope through the nose into the throat. The first part of the test assesses sensation in the larynx in order to elicit an airway protective reflex. Pulses of air are directed at points on the larynx and the reaction to this stimulus is observed through the endoscopic camera.
The second part of FEESST® entails observing how and where the food travels down the patient's throat during swallowing through an endoscopic camera with a real-time, magnified view. The food is prepared with green food coloring in order to facilitate visibility. The patient is instructed to make certain physical maneuvers, including tucking the chin or turning the head, to find the least restrictive method of travel for the food as it passes through the throat and into the stomach. The speech-language pathologist is very careful to alter the volume and thickness of the food so that patients do not have any choking sensation during the exam.
The procedure takes about ten minutes and is covered by private medical insurance and Medicare.