A Cross-sectional Study to Assess the Need for Standardisation of the Modified Mallampati and Friedman’s Scoring System
Introduction: The Modified Mallampati (MM) grading and Friedman’s Tongue Position (FTP) scores are two major scoring systems used to evaluate the oropharyngeal space. However, the current descriptions of performing these scores do not specify the route of breathing taken by the patient during th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18924/66864_CE[Ra1]_F(IS)_QC(SHK_RDW_IS)_PF1(RI_KM_OM)_PFA(RI_KM)_PN(KM).pdf |
| Summary: | Introduction: The Modified Mallampati (MM) grading and
Friedman’s Tongue Position (FTP) scores are two major scoring
systems used to evaluate the oropharyngeal space. However,
the current descriptions of performing these scores do not
specify the route of breathing taken by the patient during the
examination. The dynamic changes in the tongue and palate,
in relation to the route of breathing, may contribute to the high
interobserver variability in MM scoring.
Aim: To explore the differences in MM scores and Friedman’s
scores obtained during mouth breathing and nose breathing in
order to standardise the scoring system.
Materials and Methods: A community-based cross-sectional
study was conducted at the Departments of Anaesthesiology
and Community Medicine at Believers Church Medical College
Hospital in Central Kerala, India between April 2022 and October
2022, on 702 adults. MM scores and FTP scores were recorded
separately for each person during mouth breathing and nose
breathing. Socio-demographic variables such as age, gender,
and Body Mass Index (BMI) were also collected. The data was
analysed using the Z-test for proportions.
Results: The mean age of the study participants was 3.58±16.42
years. The majority of the participants were females (69.2%),
and more than half (59%) were above 50 years of age. Out of the
135 participants with an MM Score-1 during mouth breathing,
99 (73.3%) had higher scores during nose breathing. For the
196 individuals with an MM Score-2 during mouth breathing,
87 (44.3%) had higher scores during nose breathing. Similarly,
out of the 220 people with an MM score of -3 during mouth
breathing, 106 (48.2%) had a Score-4 during nose breathing. A
similar pattern was observed for the FTP scores.
Conclusion: The present study demonstrates significant
variability in MM and FTP scores obtained during oral and nasal
breathing, highlighting the need to standardise the route of
breathing during examination. The study suggests that advising
patients to breathe through the mouth may relax the tongue and
improve the predictive value of MM grading. |
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| ISSN: | 2249-782X 0973-709X |