Studies Evaluating FEES for Stroke Patients



Country/Study Design/N






Leder & Espinosa
Case Series


Population: Stroke.
Protocol: Patients referred for swallowing assessment were evaluated for the presence of aspiration using a bedside evaluation which was immediately followed by a Fiberoptic endoscopic examination of swallowing (FEES) test. FEES was used as the diagnostic standard.

  1. The clinical exam incorrectly identified 19 of 22 patients considered at risk for aspiration. 
  2. The clinical exam correctly identified 8 of 27 patients not at risk of aspiration.
  3. The sensitivity and specificity of the clinical assessment were 86% and 30%, respectively.
  4. The corresponding positive and negative predictive values were 50% and 73%.



Population: Stroke (35.7%), Chronic Neurologic Disease (28.6%), Other (35.7%).
Protocol: 76 outpatients referred for dysphagia evaluation were assigned to a Modified Barium Swallow (MBS) group to guide swallowing management, while 50 patients received Fiberoptic endoscopic examination of swallowing with sensory testing (FEESST). The incidence of pneumonia over a one-year period between groups was compared. Patients received feeding tubes, therapy from a speech-language pathologist based on the results obtained from the MBS/FEESST results.

  1. There was no difference in the incidence of pneumonia between the groups.
  2. At the end of one-year 14 (18.4%) patients whose management had been guided by MBS developed pneumonia, compared with 6 (12%) patients in the FEES group (p=0.33).
  3. Among 45 stroke patients the incidence of pneumonia was lower among FEES group patients (1/21 vs. 7/24, p<0.05).