Swallowing Evaluation (FEES)

At Atlantic ENT, we use advanced Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to identify the cause of swallowing difficulties and develop customized treatment plans that restore safety, comfort, and confidence.

Find Your ENT Request Appointment

Swallowing Evaluation (FEES) in Central Florida

Swallowing is something most people take for granted—until it becomes difficult or painful. Trouble swallowing, known as dysphagia, can impact nutrition, comfort, and quality of life. At Atlantic Ear, Nose & Throat, we use Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to accurately diagnose swallowing problems and identify their root causes. This state-of-the-art diagnostic test provides a real-time view of your throat and voice box as you swallow, allowing our specialists to pinpoint abnormalities and create personalized treatment plans to restore normal function.

What Is FEES?

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is a minimally invasive diagnostic procedure used to evaluate how well the muscles and structures in your throat and voice box function during swallowing. The test involves inserting a thin, flexible endoscope through the nose to visualize the swallowing process from above the vocal cords.

FEES allows our providers to observe your ability to swallow safely, detect aspiration (food or liquid entering the airway), and assess the coordination of the muscles involved in swallowing. This procedure helps determine the most effective strategies and therapies for improving swallowing function and reducing the risk of choking or aspiration-related complications.

Who Needs a Swallowing Evaluation?

A FEES examination may be recommended for patients who experience symptoms such as:

Difficulty swallowing food or liquids
Pain or discomfort while swallowing
A sensation of food “sticking” in the throat
Coughing or choking while eating or drinking
Frequent throat clearing
Wet or gurgly voice after swallowing
Unexplained weight loss or dehydration
Recurrent pneumonia or respiratory infections

Dysphagia can result from a wide range of causes, including neurological conditions, structural changes, reflux, or age-related decline in muscle coordination. Identifying the underlying issue early helps ensure effective treatment and better long-term outcomes.

What Happens During a FEES Exam?

FEES is a quick, safe, and well-tolerated procedure that can be performed conveniently in our office. Here’s what you can expect during your appointment:

1. Preparation

Before the test, your provider will review your medical history and discuss your swallowing symptoms. A topical anesthetic may be applied to numb your nasal passages for comfort.

2. Endoscopic Evaluation

A thin, flexible endoscope is gently inserted through one nostril and positioned to provide a clear view of the throat and voice box. The scope does not interfere with your ability to breathe or swallow.

3. Observation of Swallowing

You’ll be asked to swallow different food and liquid textures—such as thin liquids, thickened liquids, or soft foods—mixed with a harmless dye for visibility. As you swallow, your provider observes how food and liquid move through your throat, checking for aspiration, residue, or delayed reflexes.

4. Analysis and Recommendations

The entire procedure typically takes less than 30 minutes. Once complete, your provider will review the results with you and recommend next steps, which may include dietary modifications, swallowing therapy, or further evaluation.

Benefits of FEES

FEES is a leading diagnostic tool for swallowing disorders because it offers detailed insights that other methods may not provide. Key advantages include:

Real-time visualization of the swallowing process
Immediate results that guide treatment decisions
No radiation exposure, unlike traditional X-ray swallowing studies
Comfortable and quick, usually completed in one visit
Accurate detection of aspiration, residue, and coordination issues
Ability to assess multiple food consistencies during a single test

Because it can be performed in-office without sedation, FEES is a safe and efficient way to assess swallowing function for patients of all ages.

Conditions Diagnosed with FEES

FEES can detect a wide range of swallowing problems, including:

Neurological disorders such as stroke, Parkinson’s disease, ALS, or multiple sclerosis
Structural abnormalities like vocal cord paralysis, tumors, or scarring
Reflux-related irritation and inflammation
Post-surgical complications after head and neck surgery
Age-related weakness or coordination problems
Swallowing difficulties caused by prolonged intubation or respiratory conditions

Identifying these conditions early allows our providers to recommend appropriate interventions—whether through swallowing therapy, dietary changes, or medical treatment.

After Your Evaluation

Following your FEES examination, your provider will discuss the results in detail and outline the next steps in your care. Depending on your diagnosis, you may be referred for swallowing therapy, which uses specialized exercises and techniques to strengthen the muscles involved in swallowing and retrain coordination.

You will also receive recommendations for safe eating and drinking practices, such as food texture adjustments, posture techniques, and hydration tips. If needed, our team may collaborate with your primary care physician or gastroenterologist to ensure a comprehensive approach to your treatment.

Why Choose Atlantic ENT for Swallowing Evaluation (FEES)?

At Atlantic Ear, Nose & Throat, our multidisciplinary team combines medical expertise, advanced diagnostic technology, and compassionate care to provide accurate and effective evaluation of swallowing disorders. Our board-certified otolaryngologists work closely with licensed speech-language pathologists to ensure precise diagnosis and coordinated treatment. With convenient offices in Lake Mary, Orange City, and DeLand, we make expert swallowing care accessible across Central Florida.

Swallowing Evaluation (FEES) FAQs

Is the FEES procedure uncomfortable?

Most patients find the test mildly uncomfortable but not painful. A numbing spray is used to make the process more comfortable, and the scope does not interfere with breathing or swallowing.

Can I eat or drink before the exam?

You may be asked to avoid eating or drinking for a short time before the test. Your provider will give you specific instructions when scheduling your appointment.

How long does the test take?

The entire evaluation typically takes less than 30 minutes, with immediate review and discussion of results.

What happens if my test shows swallowing problems?

If abnormalities are found, your provider may recommend swallowing therapy, diet modifications, or medical treatment to improve safety and comfort while eating and drinking.

Is FEES covered by insurance?

In most cases, yes—FEES is considered medically necessary for diagnosing swallowing disorders and is covered by many insurance plans. Our staff can help verify your coverage before your appointment.