Sir,Anesthesiologists in developing and underdeveloped countries practice within the constraints of available resources. It is always important to plan preoperatively the type of anesthesia depending on the availability of resources.Airway management is always a nightmare to the anesthesiologist, especially where advance gadgets are not available due to cost factors or technical issues, or lack of training in a particular technique. Airway assessment hence assumes utmost importance in all situations. Many anesthesiologists have developed different airway evaluation mnemonics, like LEMON, MOANS, RODS etc., Even though these scoring systems guide us in airway management, they can be difficult to remember. As the author[1] mentions, MOUTH is an easy and uncomplicated airway assessment, I would like to extend it to MOUTHS, where ‘s’ stands for swelling which is compromising the airway management. The swelling may be due to various reasons viz, congenital, infection, immune-mediated, hemorrhagic, tumors etc., This simple modified pneumonic will help us even better in airway assessment and its management. However, we need to validate this airway scoring mnemonic in randomized controlled studies to further validate its adaptability into routine clinical practice.