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Fiberoptic endoscopic evaluation of swallowing FEES is the preferred test over videofluoroscopy in the evaluation of a swallowing disorder in any of the following conditions:. Oropharyngeal dysphagia is usually either a primary abnormality related to structural aberrations of the oropharynx or a secondary manifestation of neuromuscular disease. Causes for dysfunctional swallowing are protean. Both diagnosis and therapy of oropharyngeal dysphagia are based on functional assessment. Following the performance of a clinical examination, instrumental work-up includes evaluating specific aspects of swallowing function, judging the consequences of the swallowing dysfunction, and assessing factors that may be contributing to swallowing dysfunction. Videofluoroscopy has long been viewed as the "gold standard" for evaluation of a swallowing disorder for the comprehensive information it provides. However, it is not very efficient and accessible in certain clinical and practical situations.
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