Neck Circumference and Mallampati Classification

Difficult and failed intubations contribute to morbidly and mortality in anesthesia practice. Mallampati is one of the most widely used airway assessments but research shows it is highly variable in its ability to predict difficult intubation. Neck circumference is an objective assessment not commonly used, but has been shown to assess the degree of difficulty with intubation. Following Institutional Review Board (IRB) approval from both Charter Care and Rhode Island College, utilizing a descriptive design, 23 subjects had their neck circumference measured and Mallampati class assessed. The results revealed a relationship between increased neck circumference and Mallampati classification. The average neck circumference of the 23 subjects was 40.35 cm with an average Mallampati class of 2.54. The average neck circumference for Mallampati class 1 was 39.3 cm versus 42.8 cm for Mallampati class 4. Planning for a difficult airway and the assessments to use are highly variable. Practitioners pull from personal experiences as well as their training when it comes to how they provide care. Research has found that neck circumference is an objective assessment that correlates to difficult intubations. Mallampati is one of the standard airway assessments despite research showing that it does not accurately predict intubation difficulty. However, additional research is needed to understand the role neck circumference plays in everyday practice.