Fiberendoskopische Evaluation des Schluckens. Indikation, Technik und typische Befunde

The fiberendoscopic evaluation of swallowing (FEES) is a functional investigation aiming to find the individual swallowing problem of a patient with dysphagia and to find maneuvers, postures, and adequate consistence helping to improve the oral intake. As the mouth has to take the bolus and prepare it for the swallow, the endoscope is to be placed through the nose. Thus, endoscopes have to be less in diameter compared to gastroscopy. While novel chip-on-the-tip cameras are more and more used for FEES instead of fiberendoscopes like the acronym »FEES« implicates, in future, one should better set »flexible« for the »F« in »FEES«. During FEES, the individual pathology of swallowing, velar and laryngeal function, as well as helpful maneuvers, postures, and adequate consistence are investigated. Once they have been found out, they can be used for a training therapy, compensation, or surgical procedures aiming to improve swallowing and increase both the amount and speed of oral intake. Because FEES is a time-consuming procedure and has to be repeated during therapy, it should be carefully indicated; it is not adequate in cases of just globus pharyngis or odynophagia. Nonetheless, it's the better alternative to VFSS (video-fluorscopic swallowing study) since there is no radiation, and therefore it could be repeated many times during training intervention. In the article, technical aspects and typical findings are described.