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©2013 UpToDate ® Print Email The 3-3-2 rule for identifying a difficult airway The spatial relationships depicted here are important determinants of successful direct laryngoscopy. A) The patient can open his/her mouth sufficiently to admit three of his/her own fingers. B) The distance between the mentum and the neck/mandible junction (near the hyoid bone) is the length of three of the patient's fingers. C) The space between the superior notch of the thyroid cartilage and the neck/mandible junction, near the hyoid bone, is the length of two of the patient's fingers.