Mobile FEES Exams

What is a FEES exam?

A flexible endoscopic evaluation of swallowing (FEES) is a diagnostic procedure that provides a direct, real-time view of swallowing function. A small, flexible endoscope is passed gently through the nose and positioned above the larynx, allowing the clinician to observe how the patient swallows different food textures and liquid consistencies.

FEES is a gold standard exam for evaluating dysphagia — swallowing difficulty — and is widely used to guide dietary recommendations, identify aspiration risk, assess for silent aspiration, and direct speech therapy intervention. Unlike a modified barium swallow study (MBSS), FEES does not involve radiation, does not require transport to a radiology suite, and can be performed in virtually any setting.

What to expect during the procedure

A FEES exam takes approximately 20–30 minutes from setup to completion. The procedure is performed with the patient seated comfortably — at bedside, in a wheelchair, or in a common room chair.

The endoscope is introduced transnasally. The patient is asked to swallow a series of food and liquid items while we observe and record swallowing function in real time. The recording is reviewed immediately following the procedure.

We provide a written report including findings, dietary recommendations (using the International Dysphagia Diet Standardisation Initiative, or IDDSI, framework), and a clinical impression. For facilities, we can coordinate directly with nursing staff, dietitians, and on-site speech-language pathologists.

Who benefits from a bedside FEES?

• Post-stroke patients

  Dysphagia is a common sequela of stroke. Early, accurate assessment guides diet texture decisions and reduces aspiration pneumonia risk.

• Head and neck cancer

  Head and neck cancer patients benefit from FEES at every stage of care — before surgery, throughout radiation, and afterward — as treatment can cause complex, evolving dysphagia that requires ongoing monitoring.

• Neurological conditions

  Parkinson's disease, ALS, MS, and dementia can all affect swallowing. FEES allows us to monitor progression and adjust dietary recommendations as needed.

• Medically fragile patients

  Patients who are immunocompromised, post-surgical, on high-flow nasal cannula, or on complex medical regimens who cannot safely or practically travel to a hospital for evaluation.

• Patients unable to get an MBS

  Not every patient can access a modified barium swallow study — including those already undergoing radiation, patients who exceed equipment size or weight restrictions, and those facing limited access or long wait times. FEES provides an equally rigorous alternative without those barriers.

• Tracheostomy patients

  FEES is the preferred evaluation tool for patients with tracheostomies, including before and after Passy Muir Valve (PMV) trials.

For facilities: scheduling multiple patients

One of the practical advantages of mobile FEES is efficiency for skilled nursing facilities and hospitals. We can schedule multiple FEES exams during a single visit — often 3–6 patients depending on complexity — reducing the logistical burden on facility staff and eliminating multiple transport arrangements.

We work directly with your staff to coordinate scheduling, obtain appropriate consent, and ensure all necessary documentation is completed. Learn more about how we partner with facilities, including ongoing speech therapy services that can be paired with FEES evaluations.