Diagnostic Value of Mallampati Test in Supine and Sitting Positions with and without Phonation in Anesthesia

Airway assessment is very important in anesthesia. The aim of this study was to determine the diagnostic value of Mallampati test indicators in supine and sitting positions with and without phonation in anesthesia candidate patients.

This cross-sectional descriptive study (diagnostic approach) was done in 200 adult patients ≥16 years, undergoing surgery in hospitals affiliated with Mazandaran University of Medical Sciences, 2018-2019. Diagnostic indicators of Mallampati test, including accuracy, sensitivity, specificity, and positive and negative predictive values, in sitting and supine positions with and without phonation were determined before induction of anesthesia. Correlation between different Mallampati test methods was determined applying standard Cormac Lehane test.

Based on Cormack-lehane scoring, laryngoscopy was very difficult in 5.5% (n=11) and difficult in 12% (n= 24), respectively. The correlation coefficients between Cormack Lehane test and Mallampati test in sitting and supine positions with phonation were 0.332 and 0.284, respectively. The highest sensitivity (82.9%) and specificity (80%) were found in supine position without phonation and sitting position with phonation, respectively. In supine position with phonation, the sensitivity and specificity were 65.7 % and 67.9%, respectively. The accuracy of the sitting position with phonation was 77.4%.

The highest correlation between Malapmati test and Cormac Lehane test was in sitting position with phonation. Also, Malapmati test in supine position with phonation, has high sensitivity and specificity and is recommended as a suitable alternative for airway assessment.