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Is the modified Mallampati test performed in supine position a reliable predictor of difficult tracheal intubation?

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An Erratum to this article was published on 28 December 2010

Abstract

Management of the airway is central to the practice of anesthesia. Several bedside airway assessment methods have been proposed for preoperative identification of patients who are difficult to intubate. The modified Mallampati test (MMT) remains a time-tested technique to date for recognizing an anticipated difficult tracheal intubation as assessed by Cormack–Lehane grade. Both Mallampati and its further modification by Samsoon and Young evaluate patients in the seated position. Recently a study mentioned a change in MMT score from sitting to supine position toward the higher side. However, there is a lack of data regarding the relationship of positional change in MMT with Cormack–Lehane grade. The aim of this prospective study was to assess if MMT score observed in sitting or supine position is a better predictor of difficult tracheal intubation. One hundred and twenty-three patients of ASA physical status I and II, aged 18–60 years, who were scheduled to undergo various neurosurgical procedures were enrolled for the study. We found that the MMT in supine position has a higher positive predictive value and is associated with more true positives as compared to MMT in the sitting position.

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Authors and Affiliations

  1. Department of Neuroanesthesiology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, 110029, India

    Ashish Bindra, Hemanshu Prabhakar, Gyaninder Pal Singh & Vasudha Singhal

  2. Department of Anesthesiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India

    Zulfiqar Ali

Authors
  1. Ashish Bindra
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  2. Hemanshu Prabhakar
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  3. Gyaninder Pal Singh
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  4. Zulfiqar Ali
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  5. Vasudha Singhal
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Corresponding author

Correspondence to Hemanshu Prabhakar.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00540-010-1066-3

Appendix: Statistical terminology

Appendix: Statistical terminology

True positive (TP): :

Difficult intubation that had been predicted to be difficult

False positive (FP): :

Easy intubation that had been predicted to be difficult

True negative (TN): :

Easy intubation that had been predicted to be easy

False negative (FN): :

Difficult intubation that had been predicted to be easy

Sensitivity: :

Percentage of correctly predicted difficult intubations as a proportion of all intubations that were truly difficult, i.e., TP/(TP + FN)

Specificity: :

Percentage of correctly predicted easy intubations as a proportion of all intubations that were truly easy, i.e., TN/(TN + FP)

Positive predictive value: :

Percentage of correctly predicted difficult intubations as a proportion of all predicted difficult intubations, i.e., TP/(TP + FP)

Negative predicted value::

Percentage of correctly predicted easy intubations as a proportion of all predicted easy intubations, i.e., TN/(TN + FN)

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Bindra, A., Prabhakar, H., Singh, G.P. et al. Is the modified Mallampati test performed in supine position a reliable predictor of difficult tracheal intubation?. J Anesth 24, 482–485 (2010). https://doi.org/10.1007/s00540-010-0905-6

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  • DOI: https://doi.org/10.1007/s00540-010-0905-6

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