Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Langmore, Susan E.; Murray, Joseph

doi:10.1007/978-1-4614-3779-6_5

Cited by 16 publications

(21 citation statements)

References 48 publications

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“…After surgeon’s approval of and before the first postsurgical oral intake, all patients underwent the WST as screening tool and Fiberoptic Endoscopic Evaluation of Swallowing (FEES ® ) according to Langmore [ 23 , 24 ] as the reference standard.…”

Section: Methodsmentioning

confidence: 99%

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

Hey

Goeze

Sader

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Oropharyngeal dysphagia is one of the most common postoperative consequences in head and neck cancer patients. Above all, these patients often suffer from aspiration and limitations of oral intake. However, no reliable dysphagia screening is available for this target group. This study aimed to develop and validate a screening, FraMaDySc, based on a water swallow test (WST) for the identification of postsurgical patients with a risk of aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia in general (OD) that constituted the main reference standard. Methods A total of 184 postsurgical head and neck cancer patients were tested with a WST. The patients were, on average, 62 years old and predominantly male (71%). After WST, they underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). FEES® results were dichotomized by Penetration aspiration scale and Functional oral intake scale. Patients with a “fail” result on one of these two scales were classified as having OD. Quality criteria of WST were quantified by means of cross-tabulation with FEES® results. Results OD was found in 65% of patients, aspiration in 44%, limitations of oral intake in 56%. WST delivered a “fail” result in 65% of patients. WST showed sensitivity 91% and specificity 88% for OD. Quality criteria for aspiration (sensitivity 64%, specificity 93%) and limitations of oral intake (sensitivity 80%, specificity 87%) were lower. Conclusion FraMaDySc is a standardized, quick, and valid WST and therefore an excellent screening tool for the identification of OD in postoperative head and neck cancer patients.

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Section: Methodsmentioning

confidence: 99%

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

Hey

Goeze

Sader

et al. 2023

Eur Arch Otorhinolaryngol

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“…A standardized examination protocol, used in daily clinical practice at the outpatient clinic, was carried out. This prospectively standardized protocol comprised a clinical ear, nose, and throat examination (including cranial nerve function) performed by a laryngologist, determination of body mass index (BMI), the Functional Oral Intake Scale (FOIS) ( 58 ), the MD Anderson Dysphagia Inventory (MDADI) ( 59 – 61 ), the SNAQ ( 62 , 63 ), and a standardized FEES ( 64 – 66 ).…”

Section: Methodsmentioning

confidence: 99%

Malnutrition risk and oropharyngeal dysphagia in the chronic post-stroke phase

Huppertz

Pilz²,

Cunha³

et al. 2022

Front. Neurol.

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BackgroundOropharyngeal dysphagia (OD) and malnutrition are associated with poor clinical outcomes after stroke. The present study evaluated (1) malnutrition risk and OD-related characteristics in patients with chronic post-stroke OD, and (2) the relationship between on the one hand OD severity and on the other hand functional oral intake and dysphagia-specific quality of life.MethodsA cross-sectional study was conducted in a Dutch interdisciplinary outpatient clinic for OD. The standardized examination protocol comprised: clinical ear, nose, and throat examination, body mass index, the short nutritional assessment questionnaire (SNAQ), a standardized fiberoptic endoscopic evaluation of swallowing (FEES), the functional oral intake scale (FOIS), and the MD Anderson dysphagia inventory (MDADI).ResultsForty-two consecutive patients with chronic post-stroke OD were included. Mean (±SD) age and BMI of the population were 69.1 (±8.7) years and 26.8 (±4.1) kg/m2 respectively. Seventeen (40.4%) patients presented a moderate to high risk of malnutrition (SNAQ score≥2). The FEES examination showed moderate to severe OD in 28 (66.7%) patients. The severity of OD was significantly related to the FOIS score but not to the MDADI scores.ConclusionIn this specific sample of referred stroke patients, moderate to severe OD and moderate to high risk of malnutrition were common. Despite the use of clinical practice guidelines on stroke and a normal nutritional status at first sight, repeated screening for malnutrition and monitoring the severity and management of OD remain important elements in the care of patients with chronic post-stroke OD.

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“…We also examined penetration and/or aspiration using FEES by a board-certified otolaryngologist. Subgroup participants who opted to receive FEES within 30 min of completing the screen were assessed with a standardized set of liquid dye and solid puree trials [ 19 , 25 ]. Under FEES, penetration and/or aspiration was defined as the entry of food (either liquid dye or solid puree) into the airway (laryngeal vestibule, vocal folds, and trachea) immediately post-swallowing.…”

Section: Methodsmentioning

confidence: 99%

“…We hypothesized that participants who failed the screen were more likely to have penetration and/or aspiration during FEES. The screen and FEES were performed within 30 min of each other using standardized protocols [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting feeding-tube dependence in patients following endotracheal extubation: a two-item swallowing screen

et al. 2021

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Background To meet the surging demands for intubation and invasive ventilation as more COVID-19 patients begin their recovery, clinicians are challenged to find an ultra-brief and minimally invasive screen for postextubation dysphagia predicting feeding-tube dependence persisting for 72 h after extubation. Methods This study examined the predictive validity of a two-item swallowing screen on feeding-tube dependence over 72 h in patients following endotracheal extubation. Intensive-care-unit (ICU) patients (≥ 20 years) successfully extubated after ≥ 48 h endotracheal intubation were screened by trained nurses using the swallowing screen (comprising oral stereognosis and cough-reflex tests) 24 h postextubation. Feeding-tube dependence persisting for 72 h postextubation was abstracted from the medical record by an independent rater. To verify the results and cross-check whether the screen predicted penetration and/or aspiration during fiberoptic endoscopic evaluation of swallowing (FEES), participants agreeing to receive FEES were analyzed within 30 min of screening. Results The results showed that 95/123 participants (77.2%) failed the screen, which predicted ICU patients’ prolonged (> 72 h) feeding-tube dependence, yielding sensitivity of 0.83, specificity of 0.35, and accuracy of 0.68. Failed-screen participants had 2.96-fold higher odds of feeding-tube dependence (95% CI, 1.13–7.76). For the 38 participants receiving FEES, the swallowing screen had 0.89 sensitivity to detect feeding-tube dependence and 0.86 sensitivity to predict penetration/aspiration, although specificity had room for improvement (0.36 and 0.21, respectively). Conclusion This ultra-brief swallowing screen is sufficiently sensitive to identify high-risk patients for feeding-tube dependence persisting over 72 h after extubation. Once identified, a further assessment and care are indicated to ensure the prompt return of patients’ oral feeding. Trial registration NCT03284892, registered on September 15, 2017.

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Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Cited by 16 publications

References 48 publications

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

Malnutrition risk and oropharyngeal dysphagia in the chronic post-stroke phase

Predicting feeding-tube dependence in patients following endotracheal extubation: a two-item swallowing screen

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