A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring
Background. Mallampati scoring is a common exam method for evaluating the oropharynx as a part of the airway assessment and for anticipation of difficult intubation. It partitions the oropharynx into 4 categories with scores of 1, 2, 3, and 4. Even though its reliability is known to be limited by co...
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Wiley
2023-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/2193403 |
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| author | Rotem Naftalovich Marko Oydanich Janet Adeola Jean Daniel Eloy Daniel Rodriguez-Correa George L. Tewfik |
| author_facet | Rotem Naftalovich Marko Oydanich Janet Adeola Jean Daniel Eloy Daniel Rodriguez-Correa George L. Tewfik |
| author_sort | Rotem Naftalovich |
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| description | Background. Mallampati scoring is a common exam method for evaluating the oropharynx as a part of the airway assessment and for anticipation of difficult intubation. It partitions the oropharynx into 4 categories with scores of 1, 2, 3, and 4. Even though its reliability is known to be limited by confounding factors such as patient positioning, patient phonation, tongue protrusion, and examiner variability, the effect of respiration, i.e., inspiration and expiration, has not yet been formally studied. Methods. Mallampati scores were collected from 100 surgical patients during both inspiration and expiration and later compared to the score obtained in the medical record, determined by a board certified anesthesiologist. Results. Score deviations from the medical record reference were compared for both inspiration and expiration showing that respiration affects Mallampati scores; for some patients, the scores improved (i.e., decreased), while in others they worsened (i.e., increased). The respiratory change effect was quantified and visualized by plotting the area under the curve of the histogram of the deviations. 42% of the patients had a worsening of scores by 1 or 2 points with inspiration while 36% of the patients had a worsening of scores by 1 or 2 points with expiration. Conclusions. Mallampati scoring is commonly used in evaluating the oropharynx as a part of the airway assessment and as a screening tool for difficult intubations. However, as this study points out, the respiratory cycle substantially affects the Mallampati scoring system, with significant deviations of 1 or 2 points. In a scoring system of 4 score categories, these deviations are remarkable. |
| format | Article |
| id | doaj-art-34f097209e2b402e8abfc6dbd2acc4f7 |
| institution | Kabale University |
| issn | 1687-6970 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
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| series | Anesthesiology Research and Practice |
| spelling | doaj-art-34f097209e2b402e8abfc6dbd2acc4f72025-08-20T03:55:06ZengWileyAnesthesiology Research and Practice1687-69702023-01-01202310.1155/2023/2193403A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati ScoringRotem Naftalovich0Marko Oydanich1Janet Adeola2Jean Daniel Eloy3Daniel Rodriguez-Correa4George L. Tewfik5Department of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyBackground. Mallampati scoring is a common exam method for evaluating the oropharynx as a part of the airway assessment and for anticipation of difficult intubation. It partitions the oropharynx into 4 categories with scores of 1, 2, 3, and 4. Even though its reliability is known to be limited by confounding factors such as patient positioning, patient phonation, tongue protrusion, and examiner variability, the effect of respiration, i.e., inspiration and expiration, has not yet been formally studied. Methods. Mallampati scores were collected from 100 surgical patients during both inspiration and expiration and later compared to the score obtained in the medical record, determined by a board certified anesthesiologist. Results. Score deviations from the medical record reference were compared for both inspiration and expiration showing that respiration affects Mallampati scores; for some patients, the scores improved (i.e., decreased), while in others they worsened (i.e., increased). The respiratory change effect was quantified and visualized by plotting the area under the curve of the histogram of the deviations. 42% of the patients had a worsening of scores by 1 or 2 points with inspiration while 36% of the patients had a worsening of scores by 1 or 2 points with expiration. Conclusions. Mallampati scoring is commonly used in evaluating the oropharynx as a part of the airway assessment and as a screening tool for difficult intubations. However, as this study points out, the respiratory cycle substantially affects the Mallampati scoring system, with significant deviations of 1 or 2 points. In a scoring system of 4 score categories, these deviations are remarkable.http://dx.doi.org/10.1155/2023/2193403 |
| spellingShingle | Rotem Naftalovich Marko Oydanich Janet Adeola Jean Daniel Eloy Daniel Rodriguez-Correa George L. Tewfik A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring Anesthesiology Research and Practice |
| title | A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring |
| title_full | A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring |
| title_fullStr | A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring |
| title_full_unstemmed | A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring |
| title_short | A Prospective Cohort Study on the Respiratory Effect on Modified Mallampati Scoring |
| title_sort | prospective cohort study on the respiratory effect on modified mallampati scoring |
| url | http://dx.doi.org/10.1155/2023/2193403 |
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