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[Dysphagia] FEES Procedure
I just sent Geriann a response off line recommending that she contact you. Thanks for your reply. I also urged her to sepak with her state association to determine whether FEES is within their scope of practice and if there are any restrictions. We were grateful to you, Sue, for helping us to get FEES within the scope of practice for our licensing in NJ. Hilda Pressman
-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com]On Behalf Of Susan G.
Butler/Otolaryngology
Sent: Thursday, July 19, 2007 8:12 AM
To: gerriann jackson; dysphagia at b9.com
Subject: Re: [Dysphagia] FEES Procedure
Hi Geriann,
One of the more recent articles on safety in FEES/FEESST, that I'm aware
of is:
------------------------------
Ann Otol Rhinol Laryngol. 2005 Mar;114(3):173-6.Links
Flexible endoscopic evaluation of swallowing with sensory testing:
patient characteristics and analysis of safety in 1,340 consecutive
examinations.Aviv JE, Murry T, Zschommler A, Cohen M, Gartner C.
Voice and Swallowing Center, Department of Otolaryngology-Head and Neck
Surgery, College of Physicians and Surgeons, Columbia University,
Columbia University Medical Center, New York-Presbyterian Hospital, New
York, New York 10032, USA.
Flexible endoscopic evaluation of swallowing with sensory testing
(FEESST) is a comprehensive endoscopic assessment of the sensory and
motor components of a swallow. Previous studies addressing patient
safety issues with respect to FEESST included relatively small numbers
of patients and paid almost no attention to patient characteristics. The
purpose of this study was to determine the incidence of FEESST-related
complications in the outpatient and inpatient settings and to analyze
patient diagnoses that led to the performance of FEESST. We performed a
prospective study of FEESST complications in 1,340 consecutive
evaluations performed over a 4 1/2-year period. The primary outcome
variables were incidence of epistaxis and airway compromise. The
secondary outcome variable was underlying patient diagnoses. The
incidence of epistaxis was 1 in 1,340 (0.07%). There were no instances
of airway compromise. Stroke was the most common reason for the
performance of FEESST (343; 25.6%), followed by cardiac-related
dysphagia (298; 22.2%) following open heart surgery (169/298; 56.7%),
heart attack, congestive heart failure, or new arrhythmia. The remaining
causes were head and neck cancer (207; 15.4%), pulmonary disease (141;
10.5%), chronic neurologic disease (124; 9.3%), and acid reflux disease
(80; 6.0%). We conclude that FEESST is a relatively safe procedure for
the sensory and motor assessment of dysphagia in a cohort of patients
with a wide variety of underlying diagnoses. The emergence of cardiac
surgery as a common cause of dysphagia warrants further study.
***They reported 0/0 (0%), airway compromise 1/1340 (0.07%) nose
bleeds/epistaxis, and 47/1,340 (3.51%) incomplete exams.
If you still need the Susan Langmore abstract let me know. It was an
abstract that was probably printed in the back of the Dysphagia Journal
as a preceding of Dysphagia Research Society Meeting in 1995 (the
abstract printing may have been in 1996, I believe)..... It will be mid
next week before I can look for it - but can fax it to you if you need
it.
Susan
Susan G. Butler, PhD, CCC-SLP
Associate Professor
Center for Voice and Swallowing Disorders
Department of Otolaryngology
Wake Forest University Health Sciences
Medical Center Boulevard
Winston-Salem, NC 27157
Academic Office: (336) 716-7272
Academic Fax (336) 716-3857
Clinic: (336) 716-7157
Clinic Fax: (336) 716-8878
email: sbutler at wfubmc.edu
-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com] On Behalf Of gerriann jackson
Sent: Wednesday, July 18, 2007 7:02 PM
To: dysphagia at b9.com
Subject: [Dysphagia] FEES Procedure
To all:
I work in a smallish acute care hospital w/ attached LTC and I am
currently writing our policy and procedures for FEES. I am meeting with
our credentialing board to develop our credentialing procedure (if they
approve) I am looking for the data on FEES safety record that was
presented at the Dysphagia Research Society Meeting in
1995 by Langmore et al. Our facility's librarian could not access this
at all.
I appreciate your help,
Gerriann Jackson, M.S., CCC-SLP
Speech Pathologist
ViaHealth of Wayne
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