Which of the following is NOT part of a complete FEES examination?

• A. Use of fluoroscopy to evaluate for silent aspiration
• B. Evaluating pharyngeal and laryngeal anatomy and physiology
• C. Identifying presence and location of preswallow secretions
• D. Determining bolus flow characteristics before, during, and after the swallow

Answer: (A)

FEES relies on direct endoscopic visualization of the swallowing apparatus, so it focuses on pharyngeal and laryngeal anatomy and physiology, preswallow secretions, and how the bolus moves through and after the swallow. It provides real-time insight into airway protection, residue, and swallow timing without using radiation. Fluoroscopy, on the other hand, is radiographic imaging used in a videofluoroscopic swallow study to visualize swallowing across the oral, pharyngeal, and esophageal stages with contrast. Because FEES does not involve radiographic imaging, using fluoroscopy to evaluate for silent aspiration is not part of a complete FEES examination.