Jessica Pisegna MBS vs FEES

The Medical SLP version of a “Battle of the Bands” would be, without a doubt, a “Battle of the Instrumentals.”

As in, which is better: MBS or FEES?

The MBS has historically been viewed as the “gold standard” of instrumentals, but a LOT more research has come out about FEES since its introduction into the dysphagia world.

And Dr. Jessica Pisegna is here to talk about it in this week’s episode of The Swallow Your Pride Podcast!

Dr. Pisegna is the section chief at Boston Medical Center of the voice and swallowing center and has worked closely with the one and only Dr. Susan Langmore.

In this episode, we cover:

  • When Dr. Pisegna chooses FEES, MBS, or BOTH simultanously. 
  • What her latest research found when it comes to absent or reduced epiglottic inversion on FEES and what it can mean
  • The importance of the brand and color of food dye
  • Why FEES should be used in acute care
  • The use of residue rating scales and the consistency of clinician ratings.
  • Laryngeal sensory testing
  • The ice chip protocol and the Frazier Free Water Protocol
  •  The reliability of Penetration-Aspiration Scale (PAS) on FEES.

Prep your barium and get your scopes out, because this episode will leave you motivated to step up your game in the world of instrumental swallow studies!



Simultaneous FEES and Video Fluoroscopy (00:03:40)
Research Findings (00:06:18)
Sensitivity of FEES (00:10:00)
FEES in Acute Care (00:14:49)
Triage Protocol (00:16:17)
Simultaneous FEES and Video Fluoroscopy (00:16:45)
Turnaround Time for FEES (00:17:33)
Rating Scales for Residue (00:18:12)
Assessing Reliability Between Clinicians (00:19:48)
New Zealand Secretion Scale (00:22:15)
Global Picture of Patient Care (00:23:44)
Management of Secretions in Acute Care (00:24:39)
Laryngeal Sensory Testing (00:25:17)
Ice Chip Protocol (00:28:55)
FEES and PPIs Ratings (00:35:10)
Challenges and Considerations in Using PAS on FEES (00:38:34)
Reliability of Digest FEES (00:40:26)

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