Investigation of the availability of tongue movements in Mallampati classification

To investigate the relation of Mallampati classification with a new alternative method suggested for use in the estimation of tongue movements.

This study was conducted in the Department of Anesthesiology, Faculty of Medicine, Trakya University, Edirne, Turkey from April to October 2009. Two hundred and thirty patients were enrolled in this study. The modified Mallampati score (MMS) was devised by an anesthetist. To define tongue movements, horizontal and vertical lines were utilized. Horizontal lines passing through the mid points of the upper lip and mandible, and vertical lines passing through the right and left infraorbital points were constituted on each subject. Subjects were asked to elevate, depress, and abduct (right-left) the tip of the tongue. The scores corresponding with the movements of the tongue were determined.

Depression of the tip of the tongue (DTT) and elevation of the tip of the tongue (ETT) levels were significantly different between MMS 1, MMS 2, and MMS 3, MMS 4 groups (p=0.001). The risk of being MMS 3 or MMS 4 for the groups that cannot reach the borderline for the DTT or ETT are 5.5 times and 5.4 times higher consequently than the groups that can reach the borderline.

This new method can be combined with MMS classification, which requires clinical experience and knowledge in predicting difficult intubation.