Background Common in head and neck cancer patients, trismus can make speech and swallowing difficult and can compromise quality of life (QOL). Jaw range of motion exercise therapy may prevent or treat trismus in surgical patients. While the importance of these exercises is well‐documented, there is little literature regarding the optimal timing of exercise initiation. Methods A prospective pilot study investigated the effects of early vs late jaw exercise intervention on postoperative jaw opening and QOL measures, which were examined descriptively. Results Timing of exercise intervention was not found to significantly impact the measured outcomes. However, provisional, descriptive findings showed that jaw opening was significantly associated with multiple QOL measures, with greater jaw opening associated with improved QOL. For certain QOL measures, this positive association was stronger at earlier time points than at later time points. Conclusions The exploratory findings of this pilot study support further research into possible benefits of early jaw exercise intervention.

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Background Current American Thyroid Association (ATA) guidelines state that patients with intermediate‐risk papillary thyroid cancer (PTC) may benefit from remnant ablation. One criterion for intermediate‐risk classification is >5 positive lymph nodes (LNs). We investigate whether performing step‐sectioning of LNs increases the metastatic detection rate, thereby influencing ATA risk of recurrence (ROR) classification. Methods A retrospective review was conducted of cases in which ≥ 5 LNs were removed during thyroidectomy and ≤5 LNs were found positive for PTC. Step‐sectioning was performed on the original tissue blocks. All slides were re‐reviewed by a senior pathologist. Results Twenty patients met study criteria. Step‐sectioning significantly increased LN yield compared to standard sectioning. In total, we found 12 new positive lymph nodes; seven (58%) were in totally new lymph nodes, while five (42%) were in lymph nodes previously read as negative. All newly discovered metastases were classified as micrometastases (≤2 mm). Of the 15 patients originally classified as low‐risk, the step‐sectioning protocol impacted two patients (13%), increasing ROR stratification. Conclusion Intensive step‐sectioning reveals additional micrometastases. More detailed analysis did not identify clinically significant nodal disease likely to impact the clinical course of patients in this study. Our study supports current standards of pathology specimen handling related to LN assessment and the impact on ATA ROR classification. Nonetheless, it is important for clinicians to understand their institution's sectioning protocol utilized to report positive and total LN counts, which could impact ATA risk stratification and denote the comprehensive nature of the LN dissection that was performed.