A look at Robert Bastian and his view on an alternative examination to diagnose dysphagia that is safer for the patient.
Drawbacks of Modified Barium Swallow
- Needs a facility or hospital to complete with large equipment
- Multiple professionals must be present including a radiologist and Speech Language Pathologist
- Radiology Suite must be booked in advance
- Speech Language Pathologist must have training specifically to interpret results of MBS
- The patient is exposed to radiation during the procedure, which can be difficult if the patient receives many of these exams or has a history of cancer treatment
Where FEES Shines
- FEES is easily mobile, equipment is compact
- Can be done in a hospital, clinic, or home
- Can be completed in the physician's office to help better diagnose and treat a patient who comes in with a complaint of swallowing difficulties
- Can be completed for immediate answers while waiting for the modified barium swallow to be scheduled
- It is great to manage the rapidly changing conditions in head & neck cancer patients, and can be performed multiple times without the danger of radiation exposure.
- Can be completed at bedside to help critically ill patients maintain strength, instead of having them transport to a facility with MBS technology and radiology suite
Dr. Bastian developed videoendoscopic evaluation of dysphagia (VEED) in 1984 as an extremely useful tool to help us understand swallow problems by viewing anatomy and functional swallow, and to provide visual feedback for the patient to better understand the problem and how compensatory strategies can help.
Source: Videoendoscopic evaluation of patients with dysphagia: An adjunct to the modified barium swallow. Bastian, RW. 1991 Mar;104(3):339-50.