AIRWAY ASSESSMENT FOR PATIENTS UNDERGOING MODERATE SEDATION
In anesthesia, the Mallampati score, also Mallampati classification, is used to predict
the ease of intubation.[1] A high Mallampati score (class 3 or 4) is associated with more
difficult intubation as well as a higher incidence of sleep apnea.[2] In many ways it
assesses the height of the mouth; the distance from the tongue base to the roof of the
mouth, and therefore the amount of space in which there is to work. It is an indirect way
of assessing how difficult an intubation will be.
The Mallampati score is assessed by asking the patient (in a sitting posture) to open
his/her mouth and protrude the tongue as much as possible.[1] The anatomy of the oral
cavity is visualized; specifically, whether the base of the uvula, faucial pillars (the arches
in front of and behind the tonsils) and soft palate are visible. Scoring may be done with
or without phonation. Depending on whether the tongue is maximally protruded and/or
the patient asked to phonate, the scoring may vary.
Modified Mallampati Scoring:[3]
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Class I: Soft palate, uvula, fauces, pillars visible.
Class II: Soft palate, uvula, fauces visible.
Class III: Soft palate, base of uvula visible.
Class IV: Only hard palate visible
While Mallampati classes I and II are associated with relatively easy intubation, classes
III and IV are associated with increased difficulty.