Here is a rewritten version of the tribute, polished for clarity, flow, and emotional resonance while preserving its respectful and heartfelt tone:

A Giant in Anaesthesia Has Left Us

With deep sorrow, the global anaesthesia community mourns the loss of Dr. Seshagiri Rao Mallampati, MD—a name forever etched into the core of airway management.

Dr. Mallampati gifted the world one of the most elegant, practical, and enduring tools in modern anaesthesia: the Mallampati Score. Strikingly simple yet profoundly revolutionary, this classification system has guided generations of anaesthetists and anaesthesiologists in structured airway assessment, improving patient safety in operating theatres worldwide, day after day.

From his humble beginnings in Patchalatadiparru, Andhra Pradesh, to earning international acclaim, his life embodied scholarship, intellectual precision, humility, and selfless dedication to medical science. A proud alumnus of Andhra Medical College (Batch of 1963), he brought immense honour to his alma mater and lasting pride to the entire anaesthesia fraternity.

Few clinicians leave behind a contribution so fundamental that it becomes part of everyday medical language. Dr. Mallampati did exactly that.

The Mallampati Score (also called the Mallampati classification) is one of the most widely used bedside tools in anaesthesia to help predict the ease (or difficulty) of endotracheal intubation. It was introduced by Dr. Seshagiri Rao Mallampati in his landmark 1985 paper.

How the Test is Performed

• Patient sits upright (or semi-upright).
• Patient opens mouth as wide as possible.
• Patient protrudes tongue fully (without phonating / saying “ahh” — this is important, as phonation can artificially improve the view).
• Examiner looks into the oropharynx from eye level (no tongue depressor).
• Classification is based purely on which structures are visible.

The Modern / Most Commonly Used Version → Modified Mallampati Classification (Samsoon & Young, 1987)

This is the 4-class system used in almost all current textbooks, guidelines, and clinical practice:

• Class I — Full visibility of:
  soft palate, uvula, fauces (pillars/tonsillar pillars), and tonsils (or tonsillar beds).
• Class II — Soft palate, uvula, and fauces visible, but pillars (and often tonsils) are partially or fully obscured by the tongue.
• Class III — Only soft palate and base (root) of the uvula visible; hard palate may be seen anteriorly.
• Class IV — Only hard palate visible; soft palate and uvula completely hidden by the tongue.

(Some institutions still note a rare Class 0 variant where the epiglottis is visible even without laryngoscopy — very favourable airway.)

Clinical Meaning

• Class I & II → Generally considered favourable / easier airways.
• Class III & IV → Associated with increased risk of difficult mask ventilation and/or difficult direct laryngoscopy / intubation.

Important caveats (real-world performance):

• It is not a perfect predictor on its own (sensitivity ~50–60%, specificity better, but positive predictive value is low ~20–50%).
• Best used as part of a composite airway assessment (e.g. together with thyromental distance, mouth opening, neck mobility, upper lip bite test, etc.).
• Higher scores also correlate with increased risk of obstructive sleep apnea (OSA).

This simple, no-equipment-required visual test has saved countless lives by alerting anaesthetists to prepare alternative airway plans (video laryngoscopy, bougie, supraglottic airway, awake fibreoptic, etc.) when Class III/IV is found.

Even decades later, every time we say “Mallampati III” in the OR, we honour Dr. Mallampati’s elegant contribution to patient safety.

His legacy lives on in every airway evaluation we perform and in every safe intubation we achieve.

Rest in peace, Dr. Mallampati. Your light continues to guide us. Om Shanti. 🙏