Mallampati Score

Aka: Mallampati Score, Mallampati Classification, Mallampati Class

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II. Indication

  1. Anesthesiology evaluation to assess ease of intubation
  2. Sleep Apnea evaluation (experimental)

III. Exam

  1. Assess Tonsil and Tonsillar fossa visibility
  2. View pharynx with mouth open at rest
    1. No phonation (e.g. patient should NOT say "ahhh")
    2. No protrusion of Tongue
    3. No Tongue depressor
  3. Scoring
    1. Class 1: Entire Tonsil clearly visible
    2. Class 2: Upper half of Tonsil fossa visible
    3. Class 3: Soft and Hard Palate clearly visible
    4. Class 4: Only Hard Palate visible
  4. Images
    1. entMallampatiAll.jpg

IV. Interpretation

  1. Higher Mallampati Score (Type 4) is a higher risk
    1. More difficult intubation
    2. Associated with Sleep Apnea
  2. However, Mallampati Score 3-4 has been found a poor predictor of adverse Anesthesia events and difficult airway in several studies
    1. Very high False Positive Rate in predicting difficult airway or adverse events
    2. Green (2019) Ann Emerg Med 74(2):251-9 +PMID: 30782435 [PubMed]

V. Resources

  1. Global Anesthesiology Server Network (GASNet)
    1. http://gasnet.med.yale.edu/airway/rec07.htm

VI. References

  1. Mallampati (1985) Can Anaesth Soc J 32(4):429-34 [PubMed]

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