What is an Adam’s Apple?
Most people recognize the Adam’s apple as the noticeable bump on the front of the neck, but what exactly is it, and why does it exist? This distinctive feature, more prominent in some than others, is actually part of a larger structure called the larynx, or voice box.
While it’s commonly associated with men, women can have an Adam’s apple too—it’s just usually smaller. The size and visibility of the Adam’s apple are influenced by anatomy, hormones, and vocal development.
In this blog, we’ll dive into the specifics of what the Adam’s apple is made of, its purpose in the body, and why it differs from person to person. Whether you’re simply curious or considering cosmetic changes, understanding this feature is a fascinating exploration of anatomy and individuality.
The Anatomy of the Adam’s Apple
The Adam’s apple is part of the larynx, or voice box, which is located in the throat. It’s formed by the thyroid cartilage, a large shield-shaped structure that provides protection and support for the vocal cords. The larynx itself has several components:
Thyroid Cartilage: The largest and most prominent part of the larynx, the thyroid cartilage forms the Adam’s apple. In males, this cartilage typically grows larger and projects outward during puberty due to the influence of hormones.
Cricoid Cartilage: Located below the thyroid cartilage, this ring-shaped cartilage provides additional structure and support to the larynx and is the entryway into the trachea (a.k.a the windpipe).
Vocal Folds (Vocal Cords): These are elastic bands of tissue that vibrate to produce sound when air passes through them. They sit inside the thyroid cartilage and attach to the cartilage at a location called the anterior commissure, which is about halfway between the upper and lower border of the thyroid cartilage.
Epiglottis: A flap of cartilage that prevents food and liquid from entering the airway during swallowing.
Arytenoid Cartilages: These are small, pyramid-shaped cartilages located at the back of the larynx. They are crucial for vocal cord movement as they anchor the vocal cords and help control their tension and position.
The larynx also contains several muscles that control its movement and function. These muscles can be grouped into intrinsic and extrinsic categories:
Intrinsic Muscles: These include the thyroarytenoid, cricothyroid, and posterior cricoarytenoid muscles, among others. They control the tension and length of the vocal cords, as well as opening and closing the airway during vocalization and breathing.
Extrinsic Muscles: These muscles, such as the sternothyroid, thyrohyoid, and omohyoid, help raise, lower, and tilt the larynx. During swallowing, the extrinsic muscles elevate the larynx to protect the airway, while during vocalization, they adjust the position of the larynx to modify sound.
Together, these structures work to produce sound, protect the airway, and assist in swallowing.
Where did the term “Adam’s Apple come from?
The term “Adam’s apple” has its origins in biblical mythology. According to the story, Adam, the first man, ate forbidden fruit from the Tree of Knowledge in the Garden of Eden. Some interpretations suggest that a piece of the fruit became lodged in his throat, creating the protrusion we now associate with the Adam’s apple. While this tale is metaphorical, the name has persisted through centuries to describe the visible bump in the neck.
Embryology of the Larynx
The larynx, or voice box, begins to develop during the early stages of embryonic growth. It originates from the pharyngeal arches, structures that also contribute to the formation of the jaw, ears, and throat. By the 10th week of gestation, the laryngeal cartilages start to take shape, and the vocal cords begin forming shortly thereafter. These structures continue to grow and change throughout childhood and adolescence.
The larynx undergoes significant changes from infancy through puberty. In newborns, the larynx is positioned high in the neck, allowing simultaneous breathing and swallowing, which is crucial for feeding. As the child grows, the larynx gradually descends, altering vocal resonance and pitch.
During puberty, hormonal changes, particularly increases in testosterone in males and estrogen in females, drive further development of the larynx. In males, the larynx enlarges significantly, and the vocal cords lengthen and thicken, resulting in a deeper voice. In females, the larynx also grows, but to a lesser extent, leading to more subtle changes in vocal pitch.
The size of the Adam’s apple varies widely among individuals, regardless of gender. Factors such as body composition, neck length, and genetic predisposition all play a role.
Adam’s Apple Reduction Surgery (Tracheal Shave)
For individuals who feel self-conscious about a prominent Adam’s apple, reduction surgery—also known as a tracheal shave—is an effective solution. This procedure involves shaving down the protruding cartilage to create a smoother contour. It’s a popular option for transgender women as part of facial feminization surgery, but it’s also common in cisgender men and women who desire a less prominent neck profile.
The Procedure
A tracheal shave is typically performed under general anesthesia. I make a small incision in a natural crease of the neck to minimize visible scarring. I then use a flexible camera, called a laryngoscope, to visualize the vocal cords and ensure they are not damaged. The excess thyroid cartilage is carefully reduced while preserving the structural integrity of the larynx and protecting the vocal cords.
Recovery and Risks
Recovery from a tracheal shave is usually straightforward. Most patients experience mild swelling and discomfort for a few days but can return to normal activities within a week. As with any surgical procedure, there are risks, including changes to the voice, scarring, or infection. However, these risks are rare when the surgery is performed by an experienced facial plastic surgeon with expertise in laryngeal anatomy.
Understanding the Adam’s Apple
The Adam’s apple is more than just a visual feature of the neck—it’s a critical part of the larynx that plays a role in protecting the airway and producing sound. While its prominence varies widely among individuals, those who feel self-conscious about their Adam’s apple have options. A tracheal shave can provide a smoother neck contour while preserving the vital functions of the larynx.
Dr. Sarah Saxon is a leading double board-certified facial plastic surgeon who specializes in tracheal shave procedures and has extensive knowledge in laryngeal anatomy and function. Contact us today to schedule your tracheal shave consultation.
You May Also Like:
- Do Women Have Adam’s Apples?
- Does a Tracheal Shave Change Your Voice?
- Tracheal Shave Cost: What to Expect for Adam’s Apple Reduction Surgery
- What is Tracheal Shave Recovery Like?
- Tracheal Shave Before and After Gallery
References
Gray’s Anatomy for Students. (2020). Elsevier.
Doherty, G. M. (2015). Current Diagnosis & Treatment: Surgery. McGraw-Hill Education.
Hormonal Influence on the Laryngeal Development During Puberty. Journal of Voice, 2018.
- Zamponi V, Mazzilli R, Mazzilli F, Fantini M. Effect of sex hormones on human voice physiology: from childhood to senescence. Hormones (Athens). 2021 Dec;20(4):691-696.
