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.