Referral FAQs
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Thank you for referring your patient to Vocal Health.
Referrals for voice disorders, swallowing disorders, chronic cough and inducible laryngeal obstruction (ILO) can be sent via:
HealthLink: vlhealth
or
Email: info@vocalhealth.com.au
Please include relevant clinical information where available, including:
reason for referral
relevant medical history
current medications
relevant investigation results
imaging, endoscopy or instrumental assessment reports
specialist correspondence
Following assessment, a comprehensive report outlining clinical findings, management recommendations and ongoing rehabilitation will be forwarded to the referring practitioner.
You are also welcomed to contact us on (08) 6383 7309 to discuss your referral.
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Flexible Endoscopic Evaluation of Swallowing (FEES) is an instrumental swallowing assessment and requires a written medical referral.
If a FEES assessment is requested, please clearly state "FEES" on the referral so the appropriate appointment can be arranged.
Where appropriate, please include the specific clinical question you would like the assessment to address.
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A medical referral is not required. You are welcome to self-refer by contacting us by phone (08) 6383 7309 or email info@vocalhealth.com.au
At your first appointment, your clinician will discuss your symptoms, medical history and the ways in which the condition is affecting your daily life. The assessment will then be tailored to the reason for your referral.
We understand that attending an assessment can sometimes feel unfamiliar. Our clinicians will explain each stage clearly, answer your questions and involve you in decisions about your care.
Where appropriate, we will also communicate with your referring practitioner so that your assessment and management remain coordinated with the rest of your healthcare team.
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Indications
FEES may be considered for patients with suspected or established oropharyngeal dysphagia, particularly where instrumental assessment is required to evaluate:
suspected penetration or aspiration, including silent aspiration
pharyngeal residue
secretion management
laryngeal function and airway protection
swallowing fatigue or deterioration across a meal
the impact of neurological or progressive neurodegenerative disease on swallowing
dysphagia following stroke, head and neck cancer, surgery, prolonged intubation or critical illness
swallowing function associated with tracheostomy or following decannulation
the effectiveness of compensatory strategies or rehabilitation techniques
swallowing using usual or specifically problematic foods and fluids
swallowing function where clinical assessment alone does not adequately explain the patient's symptoms
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FFEES is a safe and generally well-tolerated procedure with a low reported complication rate. It does not involve ionising radiation or barium contrast and allows swallowing to be assessed using real foods and fluids, including foods that may be specifically problematic for the patient.
The absence of radiation exposure also allows extended assessment, repeated trials and reassessment where clinically appropriate. This can be particularly useful when evaluating fatigue, different food and fluid consistencies, or the immediate effectiveness of swallowing strategies and rehabilitation techniques.
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FEES may be contraindicated or require additional consideration in patients with:
significant nasal obstruction, trauma or recent sinonasal surgery
active or significant epistaxis
significant bleeding risk
severe agitation or inability to participate safely
significant movement disorder preventing safe examination
a history of significant vasovagal responses
medical, cardiac or respiratory instability
Anticoagulant or antiplatelet therapy is not necessarily an absolute contraindication, but should be identified on referral so that individual risk can be considered.
Please contact Vocal Health if you would like to discuss the suitability of FEES for a particular patient.