Mallampati classification
The Mallampati classification or the Mallampati test (introduced by Seshagir Mallampati in 1985 ) is used to estimate the degree of difficulty of endotracheal intubation before anesthesia . For the examination, the patient sits or stands awake and stretches the tongue out of the mouth as much as possible with the head in a neutral position without phonation and without moving the head.
Originally divided into three levels of difficulty, the modification of Samsoon and Young is often in use today, which has four levels:
- I: full visibility of the soft palate , uvula and lateral palatal arches
- II: lateral palatal arches and tip of the uvula no longer visible
- III: soft and hard palate visible
- IV: only hard palate visible
By assessing the visibility of various structures of the throat when the mouth is open, difficult intubation is to be detected in advance. However, the correlation with the degree of difficulty of the intubation and the direct view of the glottis during intubation ( classification according to Cormack and Lehane ) is not particularly high. Even in combination with other indications (short, thick neck of the patient, receding chin, poor head and neck mobility, small mouth opening), only about half of the patients can be identified in whom intubation is difficult.
Individual evidence
- ↑ SR Mallampati include: A clinical sign to predict difficult tracheal intubation: a prospective study. In: Can Anaesth Soc J. 32 (4), Jul 1985, pp. 429-434. PMID 4027773
- ↑ GL Samsoon, JR Young: Difficult tracheal intubation: A retrospective study. In: Anaesthesia. 42, 1987, pp. 487-490. PMID 3592174
- ↑ H. Langenstein, G. Cunitz: [Difficult intubation in adults]. Difficult intubation at the adult. In: Anaesthesiologist. 45 (4), Apr 1996, pp. 372-383. Review. PMID 8702056