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The Cormack-Lehane scoring system classifies laryngoscopy by the best view obtained. A grade 1 score represents full visualization of the glottis, grade 2 is a partial view, grade 3 is epiglottis only, and grade 4 indicates that no laryngeal structure was seen. Grades 3 and 4 occur rarely in practice, and only a small number of the 30% of patients scored as grade 2 are difficult to intubate. These London authors sought to improve the predictability of difficult intubation by refining the definition of grade 2 laryngoscopy as grade 2a for partial view of the glottis, and grade 2b for arytenoids only.
Among 663 adult patients undergoing elective anesthesia who were scored for laryngoscopic view and difficult intubation, 450 (68%), 205 (31%), 8…