Abstract Background and Aims: Anticipating a difficult airway is critical in anaesthesiology to minimise the perioperative complications. The modified Mallampati classification (MMC) is widely used as a bedside test, while Cormack–Lehane (CL) grading provides a direct laryngoscopic assessment. To evaluate the correlation between the MMC and CL grading in predicting difficult laryngoscopy and intubation. Methods: A prospective observational study was conducted amongst 216 patients undergoing general anaesthesia at a teaching hospital. Preoperative airway evaluation included the assessment of the MMC, and CL grading was assessed during direct laryngoscopy at the time of intubation. Demographic data, the American Society of Anesthesiologists physical status and the correlation between the two grading systems were analysed using the Chi-square tests, Spearman’s rank correlation, Kendall’s Tau-b and linear regression. Results: Amongst 216 patients, 100 (46.3%) were Modified Mallampati class 1, 96 (44.4%) were class 2, 16 (7.4%) were class 3 and 4 (1.9%) were class 4. Laryngoscopy views graded as 1 in 118 (54.6%), 2 in 85 39.4% and 3 in 13 (6.0%) patients. A statistically significant correlation was observed between Mallampati and CL grading (χ 2 = 87.16, P < 0.001). Modified Mallampati classes 3 and 4 were associated with higher grades of difficult laryngoscopy. However, grade-to-grade correlation was inconsistent, with Mallampati class 1 predicting CL Grade 1 in 65% of cases and class 2 predicting Grade 2 in 42.7% cases. Conclusion: The modified Mallampati test is a useful, simple preoperative predictor of a difficult airway. Despite a significant correlation with CL grading, it should be combined with other airway assessment parameters to enhance predictive accuracy.
Priya et al. (Thu,) studied this question.