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

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Modified Mallampati Classification

    Stratifies difficulty of endotracheal intubation based on anatomic features.
    Favorite

    INSTRUCTIONS

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

    When to Use
    Pearls/Pitfalls
    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).

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

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

    Formula

    Modified Mallampati Classification:

    Class I

    Faucial pillars, soft palate, and uvula visualized

    Class II

    Faucial pillars and soft palate visualized, but uvula masked by tongue base

    Class III

    Only soft palate visualized

    Class IV

    Soft palate not visualized

     

    Original Mallampati Classification (for historical interest):

    Class I

    Faucial pillars, soft palate, and uvula visualized

    Class II

    Faucial pillars and soft palate visualized, but uvula masked by tongue base

    Class III

    Only soft palate visualized

    Literature

    Dr. Seshagiri R. Mallampati

    About the Creator

    Seshagiri R. Mallampati, MD, is a retired anesthesiologist. He practiced at Brigham and Women's Hospital throughout his clinical career. Dr. Mallampati is perhaps best known for his eponymous airway scoring system.

    To view Dr. Seshagiri R. Mallampati's publications, visit PubMed