Swallowing assessment is a comprehensive evaluation performed to understand the cause of swallowing disorders and to determine the most appropriate treatment plan. During this assessment, it is examined whether food and liquids safely pass from the mouth to the stomach and whether there are any obstructions or risks to the airway during swallowing.
Assessment is generally performed using Flexible Endoscopic Evaluation of Swallowing (FEES) and/or Modified Barium Swallow Study (Videofluoroscopy). In some patients, only one method is used, while in other cases, both methods may be applied together. This process helps identify which food consistencies are safe to swallow, which therapy techniques can be applied, and what precautions the patient may need.
1. Flexible Endoscopic Evaluation of Swallowing (FEES) – Endoscopic Swallowing Test
- A flexible endoscope is inserted through the nose to observe the pharynx and larynx during swallowing.
- While the patient swallows foods and liquids of different consistencies (puree, liquid, solid), it is assessed whether food gets stuck in the pharynx, and whether penetration (entry into the upper laryngeal area) or aspiration (entry below the vocal cords) occurs.
- The procedure is usually brief and can be performed comfortably with local anesthesia or mild spray.
- FEES allows real-time observation of swallowing and can also be used to test the effectiveness of certain therapy techniques.
Is it possible to perform an Endoscopic Swallowing Test at home?
- The Endoscopic Swallowing Test is usually performed in a hospital or clinic.
- However, in some selected cases, it can be performed at home or in a care facility by an ENT specialist experienced in swallowing disorders.
- This is preferred in situations where patient transport is difficult or access to a clinical environment is limited.
- During the procedure, all necessary safety precautions are taken, and the risk of complications is minimized.
- Not all patients are suitable for out-of-clinic swallowing testing; suitability is determined individually.
2. Modified Barium Swallow Study (Videofluoroscopy)
- The patient swallows food and liquids containing barium of different consistencies, and the process is recorded radiologically.
- The passage of food through the esophagus, pharynx, and larynx, as well as any pauses, obstructions, or aspiration risks, is observed in detail.
- This method is used to evaluate both the overall swallowing function and the structural condition of the esophagus.
- Radiation is used during the procedure, so time and dose are limited, but it provides very detailed anatomical and functional information.
- Videofluoroscopic swallowing assessment is performed in the radiology department under special radiation protection conditions.