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Write a short note on Mallampati Classification.

General Surgery · Final Professional

Definition

The Mallampati classification is a bedside test used in airway assessment to predict the ease of laryngoscopy and intubation. With the patient sitting, mouth opened maximally and tongue protruded (without phonating), the visibility of the oropharyngeal structures is graded I–IV.

Mallampati classes I–IV: progressively less of the faucial pillars, uvula and soft palate is visible as the tongue obscures the view.

Grades & Significance

Class I:

soft palate, uvula and pillars visible.
Class II: soft palate and uvula.
Class III: soft palate and base of uvula only.
Class IV: only the hard palate is seen.
Higher classes (III–IV) predict a more difficult laryngoscopy/intubation. The test is one predictor among several — used with mouth opening, thyromental distance, neck movement and jaw protrusion — as no single test is reliable alone.

CLINICAL PEARL

Higher Mallampati (III–IV) suggests a potentially difficult airway, but the test has limited sensitivity/specificity on its own; combine it with other predictors and always have a difficult-airway plan ready.

Class	Structures visible (mouth open, tongue out)
I	Soft palate, uvula, fauces, both pillars
II	Soft palate, uvula, fauces
III	Soft palate and base of uvula only
IV	Hard palate only — soft palate not seen
Significance	III and IV predict difficult intubation

KEY POINT

Key points TO remember

Mallampati: sitting, mouth open, tongue out — grades oropharyngeal view I–IV.
I: palate+uvula+pillars; II: palate+uvula; III: base of uvula; IV: hard palate only.
Higher class (III–IV) predicts more difficult laryngoscopy/intubation.
One predictor among several — combine with mouth opening, thyromental distance, neck movement.

EXAM TIP

Sources: Morgan & Mikhail’s Clinical Anesthesiology; Miller’s Anesthesia; Ajay Yadav’s Short Textbook of Anaesthesia.

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