Airway Evaluation Paper

This paper authored by Christopher Conner and Scott Segal attempts to derive a computer model that classifies the ease or difficulty of endotracheal intubation. The computer model was derived from the analysis of the facial features of three photographs and validating it against other patients with known airway anatomies.
Patients recruited for the experiments were defined as either easy or difficult to intubate. Patients were defined as easy to intubate if their "anesthetic record described a single attempt with a Macintosh 3 blade resulting in a grade I laryngoscopic view (full exposure of the vocal cords)." Difficult intubation was defined if the patient met any of the following criteria: the need for more than 1 intubation attempt by an operator with at least 1 year of

Sunanda Gupta, Dr. Rajesh Sharma and Dr. Dimpel Jain discusses the assessment of difficult airways in patients. The paper begins by listing criteria that should be considered in any airway assessment or examination.
The first classification discussed was the Mallampati test. The Mallampati test is a system of classification that correlates the tongue size to pharyngeal size. This test is performed with the patient in the sitting position, head in a neutral position, “the mouth wide open and the tongue protruding to its maximum.” Classification is assigned according to the extent the base of tongue is able to mask the visibility of pharyngeal structures. There are four classifications according to the Mallampati test. Class I is where the soft palate, fauces, uvula, anterior and the posterior pillars are all visible. Class II is where only soft palate, fauces and uvula are visible. Class III is where oft palate and base of uvula are visible and class IV is where only the hard palate is visible while the soft palate is not visible at all. This test should be performed twice to avoid false positives or false