A response to a previously published article or letter can be submitted to the Online Correspondence section at http://www.anaesthesiacorrespondence.com. A selection of this correspondence is published several times a year in Anaesthesia. All correspondence intended for publication in Anaesthesia should be addressed to Dr David Bogod, Editor-in-Chief, and submitted as an e-mail attachment to firstname.lastname@example.org. For multi-author letters, a covering letter signed by all authors must be submitted either by post, fax (44 (0) 115 962 7670) or by e-mail as a scanned document before correspondence can be published. Alternatively, letters may be submitted typewritten on one side of paper, double spaced with wide margins to Anaesthesia, 1st Floor, Maternity Unit, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK. All paper submissions must include a signed covering letter, a disc or CD-ROM with a Word for Windows or .rtf version of the letter and an email address for the corresponding author. Copy should be prepared in the usual style of the Correspondence section. Authors must follow the advice about references and other matters contained in the Author Guidelines at http://www.blackwellpublishing.com/journals/ana/submiss.htm. Correspondence presented in any other style or format will be returned to the author for revision.
The modified Mallampati classification is one of the accepted predictors of difficult airway. The lower classes are associated with easy and higher classes with more difficult airways . Ezri et al. proposed the addition of a new airway class 0 (epiglottis seen on mouth opening and tongue protrusion), and suggested that class 0 be the easiest for tracheal intubation among the five classes . We recently encountered such a class 0 airway in an adult female, and had a slightly different experience. A 38-year-old woman, height 170 cm and weight 55 kg, was scheduled for vaginal hysterectomy. On airway examination, the epiglottis was seen (Fig. 6) correlating with Mallampati class 0. General anaesthesia was induced with thiopental and vecuronium for neuromuscular blockade. Laryngoscopy was performed with Macintosh blade 3 in the sniffing position, and the laryngoscopic view was Cormack and Lehane grade 2.
The exact correlation of the Mallampati score with the difficulty of intubation is poor . We think this is true even for class 0.