Mallampati Class Zero airway: a narrative review.

Area of Science:

• Anesthesiology
• Otolaryngology
• Emergency Medicine

Background:

• Mallampati Class Zero airway is defined by a visible epiglottis during pharyngoscopy.
• First described in 1869 and proposed as a distinct class in the modified Mallampati Classification.
• This classification aids in predicting airway manageability.

Purpose of the Study:

• To consolidate current knowledge on Mallampati Class Zero airway.
• To explore its implications for airway management strategies.
• To advocate for its inclusion as a formal classification.

Main Methods:

• A comprehensive review of existing literature on visible epiglottis during pharyngoscopy.
• Selection of 34 relevant publications for analysis.
• Synthesis of findings regarding prevalence, diagnosis, and clinical associations.

Main Results:

• Mallampati Class Zero airway is a rare finding (0.7-1.7% adults, 0.3-6% children), more common in children and females.
• Often diagnosed incidentally during dental checkups or throat examinations.
• Clinically associated with an easy airway, with no reported difficult airways in pediatric cases.

Conclusions:

• Mallampati Class Zero airway is consistently linked to easier airway management.
• Formal inclusion in the modified Mallampati Classification is recommended.
• This will enhance professional awareness, knowledge, and further research.