Historically, the use of a topical anesthetic was the preferred drug during the administration of FEES as well as during voice prostheses insertions and changes. More recent research has shown that a nasal decongestant (e.g. Otrivin) is just as effective during FEES as a topical anesthetic. A nasal decongestant is preferable because a topical anaesthetic can alter the swallowing mechanism and introduce false positives by decreasing pharyngeal sensation.
If a drug is required during the performance of FEES, Otrivin alone (or other similar nasal spray decongestant) should be used. This is assuming that there are no contraindications for the patient. Registered Speech-language pathologists (RSLPs) do not need any additional provisions to be able to obtain and administer Otrivin as it is an unscheduled drug that is available without a prescription.
RSLPs must ensure that the decongestant is not contraindicated and must document the administration of it appropriately. More information to help guide clinicians is available online at: the National Center for Biotechnology, US National Library of Medicine.
For further information, please contact Mardi Lowe, Director, Quality Assurance & Professional Practice at firstname.lastname@example.org.