Renowned Anesthesiologist Dr. Seshagiri Mallampati, Who Introduced the Mallampati Score to Predict Difficult Airways, Dies at 85

Though airway assessment techniques have evolved with imaging, video laryngoscopy, and advanced devices, the Mallampati classification remains a fundamental bedside evaluation method.
An image of Dr. Seshagiri Mallampati.
Dr. Mallampati was born in India and pursued MBBS before moving abroad for advanced training.luizfernandofalcao - Instagram
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Dr. Seshagiri Mallampati, the anesthesiologist who introduced the widely used Mallampati classification or Mallampati score for predicting the ease of endotracheal intubation, passed away on February 9 at the age of 85, in Brookline, Massachusetts, United States. The news of his death was announced by Andhra Medical College Alumni of North America general secretary Dr. Suresh Kankanala.

Early Life and Medical Education

Dr. Mallampati was born in 1941, in Patchalatadiparru, Andhra Pradesh, India, to the late Veeraiah Mallampati and the late Anasuyamma Mallampati in India, according to the obituary published by Legacy.

He pursued medical education at Andhra Medical College, from where he graduated in 1968. In 1971, he emigrated to the United States and completed his residency at Lahey Hospital & Medical Center, Massachusetts, and a clinical fellowship at Harvard Medical School.

Development of the Mallampati Score

In 1985, Dr. Mallampati and colleagues published a landmark study describing a clinical sign to predict difficult tracheal intubation. The classification system was based on the visibility of oropharyngeal structures when a patient opens their mouth and protrudes the tongue. He suggested that decreased visualisation of the soft palate, faucial pillars and uvula, have an association with the difficulty of intubation.

The original system categorized airways into three classes; it was later modified into four classes and is now known as the Mallampati classification.

This simple, non-invasive test by assessing the oral structures, became a cornerstone of preoperative assessment, used by clinicians worldwide to enhance patient safety by predicting difficult airways.

Mallampati classification of airway.
The Mallampati score became a cornerstone of pre-anesthetic evaluation. It is routinely taught in medical schools and anesthesia training programs and is integrated into airway assessment guidelines worldwide.Jmarchn, CC BY-SA 3.0, via Wikimedia Commons

How the Mallampati Score Works

The scoring system evaluates the visibility of:

  • Soft palate

  • Uvula

  • Faucial pillars

It is typically divided into:

  • Class I: Full visibility of soft palate, uvula, and pillars

  • Class II: Partial visibility of uvula

  • Class III: Only soft palate visible

  • Class IV: Only hard palate visible

Higher classes are associated with increased likelihood of difficult intubation.

The classification system has been cited extensively in medical literature and continues to be used in operating rooms, emergency departments, and critical care settings.

Dr. Seshagiri Mallampati's photo.
Dr. Mallampati was born in India and pursued medical education before moving abroad for advanced training. Anestesistaseanestesiologistas - Instagram

Career and Professional Contributions

Dr. Mallampati practiced anesthesiology for several decades and served as an Attending Anesthesiologist at Brigham and Women's Hospital, Boston and an Assistant Professor at Harvard.

Personal Life and Legacy

Dr. Mallampati passed away on February 9 at the age of 85. Obituary notices indicate he is survived by his siblings.

His name remains permanently associated with one of the most recognized clinical tools in airway management.

Though airway assessment techniques have evolved with imaging, video laryngoscopy, and advanced devices, the Mallampati classification remains a fundamental bedside evaluation method.

Dr. Mallampati’s contribution illustrates how a simple clinical observation can reshape global medical practice.

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