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A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring
Rotem Naftalovich1,2, Marko Oydanich1, Janet Adeola1
1Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, USA.
Anesthesiology Research and Practice
|September 4, 2023
Summary
Respiration significantly impacts Mallampati scores, a key airway assessment tool. This study found that breathing during the Mallampati exam can alter scores by 1-2 points in many patients.
Area of Science:
- Anesthesiology
- Airway Management
Background:
- Mallampati scoring assesses the oropharynx for airway evaluation and difficult intubation prediction.
- The system categorizes the oropharynx into 4 classes (1-4).
- Factors like patient positioning and examiner variability affect reliability, but respiration's impact is unstudied.
Purpose of the Study:
- To investigate the effect of respiration (inspiration and expiration) on Mallampati scores.
- To quantify score deviations caused by the respiratory cycle.
Main Methods:
- Mallampati scores were recorded from 100 surgical patients during both inspiration and expiration.
- Scores were compared to a reference score determined by a board-certified anesthesiologist.
Main Results:
- Respiration was found to affect Mallampati scores, causing improvements or worsening in patients.
- 42% of patients showed score worsening by 1-2 points during inspiration.
- 36% of patients showed score worsening by 1-2 points during expiration.
Conclusions:
- The respiratory cycle substantially influences Mallampati scoring.
- Deviations of 1-2 points during breathing are significant within the 4-category system.
- These findings highlight a previously unconsidered variable in airway assessment.
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