Injury to the superior laryngeal branch of the vagus during thyroidectomy: lesson or myth?

Abstract

Objective: To examine the historical evidence that the thyroidectomy performed on operatic soprano Amelita Galli-Curci was responsible for the abrupt termination of her career.

Summary background data: The superior laryngeal branch of the vagus nerve may be injured during thyroidectomy, producing vocal defects more subtle than those found after recurrent nerve injury. It is widely believed that Galli-Curci suffered superior laryngeal nerve injury during her thyroidectomy by Arnold Kegel, MD, in 1935, resulting in the termination of her career.

Methods: The authors examined contemporary press reviews after surgery, conducted interviews with colleagues and relatives of the surgeon, and compared the career of Galli-Curci with that of other singers.

Results: Evidence against the prevailing view is to be found in the fact that she continued to perform acceptably after surgery, her continued friendly relationship with the surgeon for years afterward, the absence of the typical effects of superior laryngeal nerve injury, and the presence of other explanations for the gradual decline in her vocal abilities (documentation of deterioration before surgery, physiologic changes in the larynx comparable to those found in most other famous sopranos who retire at about the same age or earlier, and the possible development of myxedema).

Conclusions: The story should no longer be perpetuated in surgical textbooks and papers.

Figure 1. Galli-Curci (A) in 1919, before any trace of the goiter is visible, (B) showing clear signs of thyroid enlargement, and (C) a few days after surgery. (Courtesy of the New York Public Library for the Performing Arts.)