Swallow Study in New York performed by NDoscopy Dysphagia Specialists
NDoscopy Dysphagia Specialists performed a specialized procedure called Flexible Endoscopic Evaluation of Swallowing. A small endoscope is passed through the nose to view the pharynx and larynx. The exam is performed at patient’s bedside for a no hassle approach. Food and liquid are provided while the swallow is viewed in real time and video-recorded for a comprehensive, detailed view of the swallowing. NDoscopy Dysphagia Specialists service the greater NYC area including the Bronx, Manhattan, Brooklyn, Queens, Long Island, Westchester and Rockland Counties. We provide services at the patient’s home as well as in nursing facilities, hospitals, rehabilitation centers, home health or other inpatient facilities. Contact us for more information!
Types of Swallowing Studies
There are two instrumental swallow assessments, the modified barium swallow study (MBS) (aka videofluoroscopy) or flexible endoscopic evaluation of swallowing (FEES) aka fiberoptic endoscopic evaluation of swallowing. Both procedures are crucial for diagnosing and treating disorders of swallowing. Both tests help to determine if food or liquids are going into the airway (termed aspiration), instead of the stomach. The MBS and FEES can also determine the reason the person is having difficulty swallowing, the safest foods and liquids and if certain positions or strategies help with swallowing. Both exams provide significant value and tools for diagnosing and treating swallowing disorders. There are unique advantages and disadvantages to each test.
Modified Barium Swallow Study
A Modified Barium Swallow study is an x-ray of the swallowing process. The procedure is performed in a radiology suite, ideally with a radiologist and a speech-language pathologist. Food and liquids of various viscosities (thickness) are coated with barium to view the material more clearly. The patient then swallows the liquid and foods that are provided and are viewed in real time, under an x-ray. Since radiation is required, the procedure is typically limited to only a few minutes and therefore may not show deficits for a full meal or fatigue issues. MBS are also more expensive and time consuming. In NYC, there is often a 6 week wait period for an available appointment. Since these procedures require a radiology suite, it is often difficult for patients with limited mobility to travel for an MBS. However, there are some patients who may benefit from having an MBS over FEES.
Flexible Endoscopic Evaluation of Swallowing
Flexible endoscopic evaluation of swallowing (FEES) is a procedure where a small endoscope with a camera is placed into the nares to view the pharynx and larynx. A physician or skilled clinician performs the FEES assessment. Food and liquids may be dyed blue or green for better viewing of the material. The protocol, established by Langmore (1988) is a comprehensive evaluation of swallowing, including three major components: (1) structural movement, sensory status, and anatomic support for swallowing; (2) ability to swallow food and liquid; and (3) response to postural, dietary, or behavioral alterations to alter the path of the bolus or the way it is swallowed.
Advantages of Flexible Endoscopic Evaluation of Swallowing (FEES)
Flexible Endosopic Evaluation of Swallowing is recommended for individuals with difficulty swallowing food or liquids.
Advantages of FEES
- FEES is completed at the patient’s bedside. MBS requires transportation to a radiology suite, which is time consuming and costly. FEES also does not require barium or radiation.
- FEES is equal or even better than MBS at detecting aspiration and severity of residue (Langmore et al, 1991, Leder et al, 1998, Kelly et al, 2007).
- FEES allows the ability to assess secretion management
- FEES can be performed throughout the entire meal, without the time constraints of an MBS due to radiation. FEES can also be performed multiple times on the same patient for biofeedback as needed.
- Assessment of the laryngeal and pharyngeal structures and function as it relates to swallowing
- Cost effective
Patient Candidates for FEES
Patients who are considered candidates for flexible endoscopic evaluation of swallowing include (but not limited to) the following:
Complain of difficulty swallowing liquid, food, or medication
Feel something stuck in their throat or pain upon swallowing
Have difficulty swallowing related to a stroke, Parkinson’s Disease, MS, CP, dementia or other neurologic impairment
Have a history of reflux
Are NPO and may be able to return to oral feedings
Currently on an altered diet who may be able to benefit from an upgrade in their diet consistency
Contact NDoscopy Dysphagia Specialist for more information about scheduling a FEES in the greater NYC area. NDoscopy does not provide Modified Barium Swallow Studies at this time.