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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    Modified Mallampati Classification

    Stratifies difficulty of endotracheal intubation based on anatomic features.


    Position patient seated upright and direct patient to open mouth and protrude tongue fully.

    When to Use
    Why Use

    Patients requiring endotracheal intubation.

    • The original Mallampati Classification had three classes of visualization, but a fourth was later added by Samsoon and Young (1987) and was shown to have greater predictive value. This modified version is the version most commonly used today.
    • While the Mallampati Classification is usually determined with the patient sitting up, a recent prospective cohort study suggests that evaluating the patient supine may better predict difficult intubation (AUC 0.82 supine over 0.7 while sitting, Hanouz 2017).
    • A class 0 has been proposed by Ezri et al (1998) to denote “extremely easy” intubation, but evidence supporting its accuracy is limited to case reports.

    Simple to use at the bedside, can be performed in less than a minute, and has good accuracy (AUC 0.83, Lee 2006) at predicting difficult airway (difficult laryngoscopy, difficult intubation, or difficult ventilation).

    Faucial pillars, soft palate, and uvula visualized
    Faucial pillars and soft palate visualized, but uvula masked by tongue base
    Only soft palate visualized
    Soft palate not visualized


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    Next Steps
    Creator Insights


    Consider strategies to improve ease of intubation in patients with a predicted difficult airway (class III-IV), e.g. video-assisted laryngoscopy, awake intubation.

    About the Creator
    Dr. Seshagiri R. Mallampati
    Are you Dr. Seshagiri R. Mallampati?