| | Videofluoroscopic swallow study (VFSS)* | Fiberoptic endoscopic evaluation of swallowing (FEES) |
| Location | - Radiology department with fluoroscopy equipment
| - Examination room or bedside
|
| Personnel | - Radiologist and speech therapist
- With or without occupational therapist
| - Endoscopist and speech therapist
- With or without occupational therapist
|
| Duration | - A few minutes, to limit radiation
| - As long as needed to gather information
|
| Media | - Contrast material is mixed with liquids and solids, as appropriate for the patient's age
| - Colored foods, different consistencies
|
| Advantages | - Permits real-time assessment of all 4 swallow phases
- Immediate recommendation for safe swallowing practice
| - Excellent evaluation of anatomy and swallowing function
- Evaluates airway protective ability and sensation, even if no liquid is consumed
- Can evaluate in any position, including during breastfeeding
- Permits an immediate recommendation for safe swallowing practice
|
| Disadvantages | - Requires fluoroscopy suite
- Radiation exposure
- Limited study time
- Limited anatomic assessment
- Limited evaluation of esophageal phase
- Variable interobserver reliability
| - Requires patient cooperation (FEES may be challenging in toddlers)
- Availability of experienced providers
- Actual swallow is obscured briefly
- Misses oral preparatory and esophageal phases
|
| Sensitivity and specificity (mostly adult data) | - Very good sensitivity with barium in airway
- Moderate specificity
| - Good sensitivity
- Very good specificity if colored food is seen in airway
|
