Visual Assessment Considerations Prior to the Mallampati Score: A Brief History

Abstract

Background: Endotracheal intubation, an essential practice performed regularly by anesthesiologists, provides an open airway to facilitate ventilation of the lungs as well as a conduit for inhalation anesthetics. Difficulties in intubation can arise due to a patient's anatomical landmarks, which can increase the mobility and mortality in safe airway management. In 1985, Dr Seshagiri Mallampati, an American anesthesiologist who encountered endotracheal difficulties despite diligent preparation, devised a non-invasive, preoperative assessment system that predicted the ease of intubation1. This assessment utilizes the visualization of the oral cavity, including the uvula, faucial pillars, and soft palate. Since the creation of the scoring system, many anesthesiologists associate Dr Mallampati with the creation of a difficult airway assessment system for safe airway management. However, less recognition is given to those who advocated on predictive factors for difficult intubation or the need for preoperative assessment prior to endotracheal intubation before the creation of the Mallampati score.