Prediction of the ease of endotracheal intubation: Mallampati and The Cormack-Lehane system


The test comprises a visual assessment of the distance from the tongue base to the roof of the mouth, and therefore the amount of space in which there is to work. It is an indirect way of assessing how difficult an intubation will be.

Original Mallampati Scoring contains 3 classes, but nowadays we are using 4 classes
 Modified Mallampati Scoring:

  • Class I: Soft palate, uvula, fauces, pillars visible.
  • Class II: Soft palate, uvula, fauces visible.
  • Class III: Soft palate, base of uvula visible.
  • Class IV: Only hard palate visible.




 The Cormack-Lehane system classifies views obtained by direct laryngoscopy based on the structures seen.


CL grades 1 (A), 2 (B), 3 (C), and 4 (D) in the SimManTM human patient simulator. a, laryngoscope blade; b, epiglottis; c, glottic opening; d, arytenoid cartilages. According to the original definition by Cormack and Lehane, most of the glottic opening can be seen with grade 1. In grade 2, only the posterior portion of the glottis or only arytenoid cartilages are visible. In grade 3, only the epiglottis but no portion of the glottis is visible, whereas in grade 4, neither the glottis nor the epiglottis can be seen.





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