Background: Face-mask ventilation is fundamental to anaesthetic practice, yet difficult mask ventilation remains challenging to predict. Ultrasonographic evaluation of palatoglossal space represents a novel approach for airway assessment. This study evaluated the predictive utility of palatoglossal space measurement for difficult mask ventilation.

Methods: This prospective observational study included 62 adults aged 18-60 years undergoing general anaesthesia. Palatoglossal space was measured ultrasonographically using a curvilinear probe in the coronal plane. Face-mask ventilation was graded using the Han scale, with grades 2-4 classified as difficult mask ventilation.

Results: The study population had mean age 42.5 ± 15.2 years with 51.6% males. Easy mask ventilation (Han score 1) occurred in 80.6% of patients, while 19.4% had difficult mask ventilation (Han score 2). Mean palatoglossal space was 0.78 ± 0.12 cm in easy ventilation group versus 0.73 ± 0.13 cm in difficult ventilation group, showing a trend but no statistical significance (p = 0.207). ROC analysis revealed limited discriminatory ability (AUC = 0.612, p = 0.207) with optimal cut-off of ≤0.75 cm yielding sensitivity 58.3%, specificity 64.0%, PPV 28.0%, and NPV 86.5%.