Flexible Endoscopic Evaluation of Swallowing With Sensory Testing

Question 1

FEEST

Answer 1

Examines:
- Airway protection: pulse of air to the hypopharyngeal tissues innervated by the internal branch of the superior laryngeal nerve (SLN) in order to elicit the laryngeal adductor reflex (LAR), a fundamental, brainstem-mediated airway protective reflex

Question 2

Advantages

Answer 2

• Does not require radiation
• Natural food (dyed green)
• Conducted anywhere (office, bedside, clinic)

Question 3

Advantages

Answer 3

Can observe:

• Airway closure (TVF and FVF)
• Arytenoid mobility
• Amount and location of secretions
• Frequency of spontaneous swallowing
• Residue build-up
• Aspiration before and after the swallow
• Bolus coordination
• Fatigue over meal
• Altered anatomy
• Effectiveness of postural change

Question 4

Disadvantages

Answer 4

• Invasive, uncomfortable, painful
• Cannot observe oral stage
• Cannot see larynx during swallow
• Requires skill