The Instrumental Gold Standard: Fees

Daniele Farneti


An instrumental examination of swallowing, has to provide a direct visualization of the effectors, furnishing information on their functional status: all in real-time that is, sometimes, just a few seconds. The real time evaluation of the afferent and efferent components of the pharyngeal reflex (sensation and motility, respectively) are equally important. In relation to its complexity, an instrumental examination that gives the clinician comprehensive information on the entire swallowing act, does not exist. The endoscopic examination of swallowing brings light inside dark cavities, allowing a detailed view of the surface anatomy of the effectors and their functioning during the passage of material other than air, which usually contains (bolus, ascending and descending secretions, gastric content, drugs, foreign bodies). Compared with a dynamic radiological study of swallowing, the endoscopic technique has structural limitations. In the following chapter, these limits will be discussed as well as, in the light of the instrumentation available today, how they can be overcome, getting information useful for diagnostic purposes but especially in the planning of therapy.


Instrumental examination; FEES; O-FEES; Endoscopy; Fluoroscopy; VFSS; MBS

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