VESS is a comprehensive, often stand-alone methodology patterned in many ways after the videofluoroscopic swallowing study (VFSS).VFSS uses three consistencies of food material – liquid, puree, and solid – mixed with barium and administered under the supervision of a speech pathologist in the radiography suite of a hospital.By contrast, VESS uses visual videoendoscopic imaging of the swallowing tract. The patient’s anatomy and neurological examination (palate, pharynx, and larynx) are first assessed in detail using various elicitation techniques. The presence or absence of retained saliva is next noted.Finally, the patient is offered, in an appropriate sequence, water, pudding, and cracker each stained with food coloring to assess swallowing ability. When there is question about esophageal function, VFSS may also need to be done.When VFSS has already been done, or when follow-up swallowing studies are needed, VESS typically is used as an alternative to VFSS.