Upper Lip Bite Test vs. Mallampati Score for Predicting Difficult Intubation

The Mallampati score, which assesses mouth opening and tongue/oral pharynx size, is widely used to predict difficult airways. Recently, investigators reported that a patient’s ability . . .

The Mallampati score, which assesses mouth opening and tongue/oral pharynx size, is widely used to predict difficult airways. Recently, investigators reported that a patient’s ability to eclipse the entire upper lip with the lower incisors (the upper lip bite test [ULBT]) correlated with difficult intubation (JWEM Mar 12 2003). To assess the clinical utility of the ULBT, researchers compared it with the Mallampati score in 1425 patients undergoing elective anesthesia.

Two trained observers simultaneously assessed both tests. The ULBT could not be assessed in 171 patients (12%), most of whom were edentulous, and Mallampati score could not be assessed in 6 patients (0.4). Interobserver agreement (calculated from a prestudy assessment in 45 pat…

Reviewing Author

Ron M. Walls, MD, FRCPC, FACEP, FAAEM