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Letters to the Editor

Pharyngoscopic Views

Ezri, Tiberiu MD; Cohen, Itzhak MD; Geva, Daniel MD; Szmuk, Peter MD

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doi: 10.1213/00000539-199809000-00065
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To the Editor:

We would like to draw the readers' attention to an interesting clinical observation regarding pharyngoscopic views. According to the Samsoon and Young's [1] modification of the Mallampati classification, the views of the anatomical position of the tongue relative to the pharyngeal structures can be divided into four classes. In patients with a Class 1 pharyngoscopic view, the uvula and soft palate are visible, predicting an easy intubation [2].

Occasionally, we have observed that even the epiglottis (tip and posterior aspect) can be visualized on mouth opening and protrusion of the tongue. In all of these patients, the endotracheal intubation was easy. We propose that another class, 0 = visualization of epiglottis at pharyngoscopic view, should be added to the classical pharyngoscopic view classification.

Tiberiu Ezri, MD

Itzhak Cohen, MD

Daniel Geva, MD

Department of Anesthesiology; Kaplan Hospital; Rehovot, Israel

Peter Szmuk, MD

Department of Anesthesiology; The University of Texas at Houston Medical School; Houston, TX 77030


1. Samsoon GLT, Young JRB. Difficult tracheal intubation: a retrospective study. Anaesthesia 1987;42:487-90.
2. Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult intubation: a prospective study. Can J Anaesth 1985;32:429-34.
© 1998 International Anesthesia Research Society