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Top Questions

What is the Adam’s apple?

What functions does the thyroid cartilage serve?

How does the Adam’s apple change during puberty?

Why do Adam’s apples vary in size among individuals?

What are the risks of surgically modifying the Adam’s apple?

Adam’s apple, in humans, visible V-shaped projection at the front of the neck formed by the thyroid cartilage of the larynx (voice box). It becomes especially noticeable during puberty, particularly in males, as hormonal changes stimulate growth of the larynx. Although often associated with male anatomy, the structure is present in all humans to varying degrees.

Function

The Adam’s apple itself is not a separate structure but rather a feature produced by the angle at which the anterior laminae of the thyroid cartilage meet. This tissue serves several important functions. Primarily, the thyroid cartilage protects the vocal cords, which are housed within the larynx, and provides attachment points for muscles and ligaments involved in voice production and swallowing. The prominence is also used in medicine to locate other structures. For example, physicians may use it to locate the larynx or the cricothyroid membrane (situated immediately below the prominence) during routine or emergency procedures.

Development and variations

The Adam’s apple essentially reflects structural changes that influence voice characteristics. During puberty, rising levels of sex hormones—particularly testosterone—stimulate the enlargement of the larynx. As the thyroid cartilage grows, its two laminae fuse, pushing the cartilage outward. This enlargement of the larynx lengthens and thickens the vocal cords, which lowers vocal pitch.

The size and prominence of the Adam’s apple vary considerably among individuals. Differences in the angle at which the laminae join, for example, determine the extent to which the Adam’s apple is visible. In females the laminae meet at an angle of about 120 degrees, compared to roughly 90 degrees in males. Variations may also occur as a result of genetic differences, hormonal or medical conditions, or medical transitions in transgender individuals receiving hormone therapy during puberty.

Surgical modification

The Adam’s apple may be altered surgically for medical or cosmetic reasons. Chondrolaryngoplasty (tracheal shave) is a procedure performed to reduce the prominence of the thyroid cartilage, commonly as part of gender-affirming surgery. In rare cases surgery involving the thyroid cartilage may be required to treat trauma, tumors, or airway obstruction. Procedures that alter the thyroid cartilage carry potential risks, including hoarseness, voice changes, damage to the vocal cords, scarring, and infection. Particularly in gender-affirming care, however, reduction of the laryngeal prominence can improve psychological well-being and body congruence for some patients.