Fiberoptic Endoscopic Evaluation of Swallowing (FEES) & Related Dysphagia Concepts

Vocabulary flashcards summarizing core terms, structures, procedures, and considerations related to FEES, VFSS, and dysphagia assessment presented in the lecture.

Dysphagia

A disorder characterized by difficulty or discomfort in swallowing.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

An instrumental, endoscopic procedure that directly visualizes pharyngeal swallowing anatomy and physiology using a flexible scope passed transnasally.

Videofluoroscopic Swallow Study (VFSS)

A radiographic (fluoroscopic) examination of oral, pharyngeal, and often esophageal swallowing using barium-coated materials.

Upper Aerodigestive Mechanism

Combined structures of the upper airway and digestive tract involved in swallowing—nasal cavity, oral cavity, pharynx, larynx, and proximal esophagus.

Whiteout

Momentary loss of the endoscopic image during FEES at the height of the swallow when pharyngeal walls contract around the scope tip.

Pooled Secretions

Accumulations of saliva or residue in the pharynx or larynx that can be visualized during FEES and may indicate impaired clearance.

Velopharyngeal Closure

Elevation of the soft palate and medial movement of lateral pharyngeal walls to seal the nasopharynx during speech and swallow.

Hypopharynx

Inferior portion of the pharynx that extends from the tip of the epiglottis to the upper esophageal sphincter; visualized in FEES.

Laryngeal Function

Roles of the larynx in respiration, phonation, and airway protection (e.g., cough, breath-hold) assessed during FEES.

Arytenoid Cartilage

Paired cartilages atop the cricoid that move the vocal folds; seen clearly with a transnasal flexible endoscope.

Epiglottis

Leaf-shaped cartilage that retroflexes to protect the airway during swallowing.

Piriform Sinus

Pharyngeal recesses beside the laryngeal opening where residue may collect; directly viewed in FEES.

Posterior Esophageal Inlet

Entrance to the cervical esophagus located behind the larynx; landmark in endoscopic swallow exams.

Bird’s-Eye View

Superior, straight-down visualization of pharyngeal and laryngeal structures provided by FEES.

Barium

Radiopaque contrast medium mixed with food/liquid for VFSS; contraindicated in allergy.

Bolus

Cohesive mass of food or liquid prepared for swallow.

Aspiration

Entry of material below the level of the vocal folds into the airway.

Biofeedback (in FEES)

Real-time visual feedback of swallowing structures used therapeutically during endoscopic evaluation.

Contraindications (FEES)

Conditions such as unstable facial fractures, severe agitation, or bleeding disorders that preclude safe endoscopic assessment.

Sensory Testing

FEES component assessing laryngopharyngeal sensation via light tactile or air-pulse stimuli.

Mixed Textures

Foods combining liquid and solid components (e.g., cereal with milk) examined during swallow trials.

Fiberoptic Endoscope

Flexible, light-conducting instrument inserted through the nare to visualize internal anatomy.

Fluoroscopy

Real-time X-ray imaging technique used during VFSS to observe bolus transit.

Compensatory Maneuvers

Swallowing strategies (e.g., chin tuck, head turn) tested during instrumental exams to improve safety/efficiency.

Transnasal Insertion

Passage of the endoscope through the nasal cavity into the pharynx for FEES.

Lateral View (VFSS)

Side-on radiographic perspective showing bolus flow and structural movement during swallow.

Radiation Exposure

Ionizing radiation received during VFSS, limiting exam time and frequency.

Secretions (Visualization)

Observation of saliva or mucus accumulation in FEES, often missed on fluoroscopy due to lack of contrast.

Portable Examination

Ability to bring FEES equipment to the bedside or ICU, avoiding transport of medically fragile patients.