Which assessment is considered instrumental for evaluating swallowing?

• A. Videofluoroscopic Swallow Study (VFSS)
• B. Fibroendoscopic Evaluation of Swallowing (FEES)
• C. 3 oz water swallow test
• D. TOR-BSST

Answer: (B)

Instrumental swallowing assessments use instrumentation to visualize or measure how the swallow works. FEES fits this role because it uses a flexible endoscope passed through the nose to directly view the pharynx and larynx while the person swallows. This allows real-time observation of how well the airway is protected, whether there is residue in areas like the valleculae or piriform sinuses, and whether material penetrates or is aspirated. It can be performed at the bedside and doesn’t involve radiation, making it practical for repeated or hard-to-transport patients. In contrast, the other options are bedside screening tools that assess risk or basic swallowing performance without visualizing the swallow’s internal mechanics, so they aren’t considered instrumental evaluations.