FEESST: Flexible Endosocpic Evaluation of Swallowing with Sensory Testing Aviv J, Murray T. Pleural Publishing. Oxford, 2005. ISBN 1-59756-000-6

FEESST is the fibreoptic endoscopic evaluation of swallowing with sensory testing. This is an extension of the more popular FEES. The authors have put together an easily readable monologue arguing the valuable role of FEESST in clinical decision-making. The first chapter covers the anatomy and physiology of swallowing with some basic pointers on the technique of fibreoptic nasendoscopy. The authors then move on to detailing the FEESST technique either by using a modified transnasal sensory endoscope or using a regular endoscope with a sensory endosheath. The most important component is the calibration of the air pulse sensory stimulating device which is designed to administer discrete pulses of air at varying pressures. The authors have not explained the reasons for using air rather than liquids or instrumentation as the sensory stimulus. The authors then discuss the use of FEESST in different populations including stroke patients, elderly and patients in whom aspiration is suspected. Various cases are used to highlight the value of FEESST. The development and technique of transnasal oesophagoscopy is discussed. It is recommended in persistent laryngopharyngeal reflux symptoms despite appropriate therapy. It would have been nice to have seen a section detailing the difficulties with these techniques that new users may encounter. Overall, this book is well written and easy to read with colour illustrations. Otolaryngologists and professionals with an interest in speech and swallowing problems will find this book instructive particularly in the increasingly ‘office-based-diagnosis' setting.