Table 1 - Indications for FEES vs. Fluoroscopy Procedure

From the following article

Endoscopic evaluation of oral and pharyngeal phases of swallowing

Susan E. Langmore

GI Motility online (2006)


Indications for modified barium swallow study (MBS):
 Unknown medical etiology; vague symptoms; need comprehensive view
 Visualize submucosal anatomy (e.g., cervical osteophytes)
 Assess oral stage/base-of-tongue movement
 UES stricture/hypertonicity?
 Examine movement of multiple structures at height of swallow
 Voicing with tracheoesophageal prosthesis : what is vibrating?
 Laryngectomy with complaints
Indications for fluoroscopy: MBS and/or barium swallow (esophagram)
 Globus complaints: do both
 Esophageal symptoms: do both or just barium swallow
 Fistula after surgery? Barium swallow alone
Indications for FEES: logistic reasons
 Fluoroscopy not available
 Transportation to radiology risky; medically fragile patient
 Transportation to a hospital problematic
 Family input desired during exam
 Positioning problematic: contractures, quad, neck halo, obese, on ventilator
 Concern about radiation
Indications for FEES: clinical reasons
 Visualize surface anatomy, mucosal abnormalities, resection, etc.
 Velopharyngeal incompetence
 Visualize laryngeal movement/vocal fold mobility
 Severe dysphagia; need conservative exam: compromised pulmonary clearance
 Clinical question of secretions management
 Extended therapeutic exam needed/ desired
 Biofeedback is desired: therapy session