Table 3.

Strengths and limitations of VFSS and FEES

	Strengths	Limitations
Videofluoroscopy (VFSS)	Direct visualization of oral pharungeal and esophageal structures in real time. Structural movements and bolus flow can be directly evaluated. Conpensatory stretegies can be evaluated and their effectiveness immediately determined. Cricopharyngeal function (opening) can be directly visualized. Anatomical structures can be directly evaluated.	Radiation exposure Limited space for patient positioning may be problematic for obese patients or those with contractures. Required the use of oral contrast for visualization.
Videoendoscopy (FEES)	Can be performed at the bedside with portable equipment Does not require the use of contrast. Regular food can be used during the evaluation. The larynx is directly visualized. The presence, quantity and management of secretions can be directly evaluated.	The oral and esophageal stages are not visualized Bounce back of the light during the swallow (white out) impedes direct visualization of structures during swallowing limiting evaluation to immediately before and after. Evaluation of bolus flow is limited by the lack of oral and esophageal information.