Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population.
BACKGROUND
The treatment of head and neck cancer is associated with significant dysphagia and morbidity. Prescribing a safe oral diet in this population is challenging.


METHODS
Data from 116 consecutive patients having 189 fiber-optic endoscopic evaluation of swallowing (FEES) examinations over a 3-year period were analyzed. All patients had been treated for head and neck cancer and subsequently were assessed by FEES. The primary outcome was the incidence of swallowing-related adverse events resulting from the FEES-based dietary recommendations.


RESULTS
There were 10 episodes of aspiration pneumonia, 4 episodes of airway obstruction, 3 unanticipated insertions of gastrostomy tubes, and 2 unexplained deaths within the study period. The overall rate of adverse events was 10.1%. The only statistically significant predictor of adverse events was the Rosenbek score (p = .03).


CONCLUSIONS
Our experience is that FEES guides appropriate and safe diet recommendations in this population.
Section of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Michael W
MW
Deutschmann
Alanna
A
McDonough
Joseph C
JC
Dort
Erika
E
Dort
Steve
S
Nakoneshny
T Wayne
TW
Matthews
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000178:diet therapy; D004035:Diet Therapy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged