What provides the most direct view for evaluating swallowing in a patient with suspected recurrent laryngeal nerve damage?

Fiberoptic endoscopic evaluation of swallowing (FEES) is the best choice for providing a direct view of the swallowing process, particularly in patients with suspected recurrent laryngeal nerve damage. This technique involves the insertion of a flexible endoscope through the nose and into the throat, allowing clinicians to visualize the anatomy and function of the larynx and surrounding structures in real-time as the patient swallows.

FEES is particularly adept at assessing aspects such as laryngeal movement, coordination, and the presence of aspiration or penetration during swallowing. In cases of recurrent laryngeal nerve damage, which affects the movement of the vocal cords and can lead to aspiration, the detailed visualization offered by FEES allows for a more accurate evaluation of these crucial areas.

While videofluoroscopic swallowing studies (VFSS) provide a dynamic assessment of swallowing, they use radiographic imaging and may not offer the same level of direct observation of laryngeal function as FEES. Other options, such as upper gastrointestinal series and videostroboscopic examinations, are not focused on evaluating swallowing dynamics or the specific functioning of the laryngeal structures related to nerve damage. Thus, FEES stands out as the most effective method for directly assessing swallowing in