A 52-year-old male patient is posted for elective abdominal surgery. During pre-anesthetic evaluation, the anesthesiologist performs Mallampati grading. Which Mallampati grade is the most common finding in the general population?
A. Mallampati Grade IV
B. Mallampati Grade I
C. Mallampati Grade II
D. Mallampati Grade III
Explanation
Mallampati Classification Overview
The Mallampati score is a simple bedside test for predicting difficult intubation based on visualization of pharyngeal structures with the mouth open and tongue protruded.
Mallampati Grades and Prevalence
Table
Grade
Structures Visible
Prevalence in Population
Difficulty Risk
I
Soft palate, fauces, uvula, pillars
~20-25%
Minimal
II
Soft palate, fauces, uvula (partially)
~60-65%
Low
III
Soft palate, base of uvula
~10-15%
Moderate
IV
Hard palate only
~2-5%
High
Key Point
Mallampati Grade II is the most common finding in the general population, occurring in approximately 60–65% of healthy individuals.
High-YieldNEET PG
Grade II is considered normal and does not predict difficult intubation. Only Grade III and IV correlate with increased risk of difficult airway and failed intubation.
Clinical Pearl
The Mallampati test must be performed with the patient sitting upright, mouth fully open, tongue fully protruded, and WITHOUT phonation. Improper positioning leads to false Grade III/IV readings.
Mnemonic
MIII = Moderate risk; MIV = Major risk (difficult airway). Grade II is the "sweet spot" and most common.
Limitations of Mallampati Scoring
Modest positive predictive value (~10–15%) for difficult intubation
High negative predictive value (~95%)
Should be combined with other airway assessment parameters (thyromental distance, sternomental distance, neck mobility, mouth opening)
Obesity, pregnancy, and edema can increase the grade transiently
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