{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:16:06Z","timestamp":1778825766278,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T00:00:00Z","timestamp":1405555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To determine whether Mallampati class correlates with Cormack\u2010Lehane grade in obese adults, and investigate a novel airway trajectory measurement (ATM) to anticipate difficult laryngoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort plus a pilot study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred eighty\u2010four nonobese and 160 obese adults underwent laryngoscopy. Spearman correlations, gamma coefficients (G), and Kendall's \u03c4 investigated body mass index (BMI):Mallampati, BMI: Cormack\u2010Lehane, and Mallampati:Cormack\u2010Lehane. A z test compared the two groups. Twenty\u2010six volunteers had neck x\u2010rays taken in the sniffing position to examine trajectories to the larynges (ATM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Positive predictive value of high Mallampati for difficult laryngoscopy was 8.57%. BMI did not correlate with Mallampati (<jats:italic>r<\/jats:italic>\u2009=\u20090.055 [nonobese], <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.056 [obese]) or Cormack\u2010Lehane [<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.014 [nonobese], <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.022 [obese]). Among nonobese adults, gamma coefficients for BMI:Mallampati was 0.039 (<jats:italic>P<\/jats:italic>\u2009=\u2009.63), for BMI:Cormack\u2010Lehane was 0.02 (<jats:italic>P<\/jats:italic>\u2009=\u2009.85), and for Mallampati:Cormack\u2010Lehane was 0.43 (<jats:italic>P<\/jats:italic>\u2009=\u2009.004). Among obese adults, gamma coefficients for BMI:Mallampati was \u22120.127 (<jats:italic>P<\/jats:italic>\u2009=\u2009.16), for BMI:Cormack\u2010Lehane was 0.014 (<jats:italic>P<\/jats:italic>\u2009=\u2009.88), and for Mallampati:Cormack\u2010Lehane was 0.365 (<jats:italic>P<\/jats:italic>\u2009=\u2009.01). Kendall's \u03c4 were comparable to gamma coefficients in all analyses. When comparing gamma coefficients for Mallampati:Cormack\u2010Lehane among the nonobese and obese, z\u2009=\u20090.04 (<jats:italic>P<\/jats:italic>\u2009=\u2009.98). In the ATM study, only Mallampati and upper lip bite test had a significant relationship (G\u2009=\u20091.00, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mallampati correlates poorly with Cormack\u2010Lehane, regardless of BMI. Pilot data suggest that ATM is feasible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 125:161\u2013166, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24829","type":"journal-article","created":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T14:07:24Z","timestamp":1405606044000},"page":"161-166","source":"Crossref","is-referenced-by-count":17,"title":["Mallampati class, obesity, and a novel airway trajectory measurement to predict difficult laryngoscopy"],"prefix":"10.1002","volume":"125","author":[{"given":"Scott L.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington Valley Medical Center Renton Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clint","family":"Hosford","sequence":"additional","affiliation":[{"name":"Department of Medical Education University of North Dakota Grand Forks North Dakota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quyen T.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve M.","family":"Parnes","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Albany Medical College Albany New York U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley M.","family":"Shapshay","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Albany Medical College Albany New York U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,7,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03011357"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1984.tb08932.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1987.tb04039.x"},{"key":"e_1_2_7_5_1","unstructured":"OgdenCL CarrollMD. 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