When is endoscopic examination of swallowing particularly useful?

Endoscopic examination of swallowing, particularly through flexible endoscopic evaluation of swallowing (FEES), provides a direct view of the swallowing process, allowing for the assessment of various components involved in the act of swallowing. The key purpose of this examination is to visualize the anatomy and functionality of the structures involved in swallowing, which includes the ability to evaluate the risk of aspiration and assess the presence of pharyngeal secretions.

In this context, assessing volumes of pharyngeal secretions is crucial. During the swallowing process, secretions play a significant role in lubrication and the overall safety and efficiency of swallowing. An endoscopic evaluation can help to identify any abnormal amounts of secretions, which may contribute to impaired swallowing or aspiration risk. It is particularly useful in providing insights on how these secretions may affect the flow of food and liquid during swallowing.

The other options, while relevant aspects of swallowing assessment, do not capture the primary utility of endoscopy in the same way. For example, assessing hyolaryngeal elevation is better suited for other types of evaluations, such as videofluoroscopic swallow studies, where dynamic movement can be recorded. Evaluating penetration into the larynx focuses on a specific event during swallowing, and measuring the efficiency