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Updated: Jul 26, 2025
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Published on: December 6, 2016
Reliability of Friedman Staging System and Modified Mallampati Scoring as clinical assessment methods for Obstructive
Deepika J Nair1, Sapna N K Varma1, Parvathy Ghosh1
1Department of Orthodontics and Dentofacial Orthopedics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Objective:
To assess the utility of oropharyngeal crowding indicators as predictors of Obstructive Sleep Apnea (OSA).
Methods:
STOP-BANG Questionnaire was administered to 145 adults. Of the 95 with high OSA risk, 42 underwent polysomnography. Intraoral space was assessed using modified Mallampati (MMP) and Friedman Scoring (FS) System.
Results:
Twenty-four were found to have OSA by polysomnography. Most with low risk (86%) had only Class I MMP. Whereas Class III and IV were seen in 37.9% and 17.9% patients with high risk (p < .001) and 50% and 20.8% patients with OSA (p < .831), respectively. All with low risk had Stage 1 FS. Stages 3 and 4 were observed in 27.4% and 1.1% in the high-risk group (p < .001) and in 29.2% and 4.2% with OSA (p < .092), respectively.
Conclusion:
In limited settings, either MMP or FS scores along with the STOP-BANG questionnaire can be used to diagnose OSA.
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