Which statement about FEES is true?

• A. FEES relies on fluoroscopy to visualize swallowing.
• B. FEES can be as sensitive as videofluoroscopy for detecting aspiration.
• C. FEES cannot evaluate silent aspiration.
• D. FEES provides visualization of the esophageal phase better than the pharyngeal phase.

Answer: (B)

FEES uses a flexible endoscope to directly visualize the larynx and pharynx during swallowing, not fluoroscopy. This direct view lets clinicians see whether material enters the airway, which makes FEES highly capable of detecting airway invasion. With careful technique and evaluation across different textures and volumes, its sensitivity for identifying aspiration can be comparable to videofluoroscopy. FEES also has the advantage of revealing silent aspiration, since there’s no need for a patient to cough for airway invasion to be observed. However, it doesn’t visualize the esophageal phase as well as videofluoroscopy, which is a limitation. So the statement that FEES can be as sensitive as videofluoroscopy for detecting aspiration is the best fit.