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What to Know About the Adam’s Apple

Medically Reviewed by Dan Brennan, MD on November 27, 2021

‌The Adam’s apple — also known as the laryngeal prominence — is the cartilage that wraps around the front of your larynx — or voice box. The name "Adam's" apple possibly come from the story of Adam and Eve in the Bible — where Adam ate an apple, the forbidden fruit, which became lodged in his throat. While the Adam's apple doesn’t have much to do with apples, it protects your voice box and vocal cords from harm.

The Structure of the Adam’s Apple

The Adam’s apple is made up of the thyroid cartilage. Cartilage is the same tissue that makes up your nose, ears, and windpipe (i.e., trachea). The voice box and windpipe have several kinds of cartilage, which work together to make sure your airways stay clear and you’re able to speak. Some of these cartilages include: 

  • Thyroid cartilage. This cartilage is the largest of these cartilages. It makes up the Adam’s apple and surrounds the front of the voice box and windpipe. It functions to protect the entire front of the neck. 
  • Cricoid cartilage. This cartilage sits toward the bottom of the neck and is ring-shaped. It's the only cartilage wrapping completely around the windpipe.
  • Epiglottic cartilage. This cartilage is one of the most important, as it allows air to pass through into the lungs. It's flap-shaped, and it sits right underneath the thyroid cartilage. The epiglottic cartilage also stops food from entering the airway every time you eat.
  • Arytenoid cartilage. This cartilage plays a major role in how you speak. It's attached to the vocal folds and helps move the vocal cords.
  • Corniculate cartilage. This cartilage has the job of making sure the arytenoid cartilage doesn't move out of place. 
  • Cuneiform cartilage. This cartilage supports the epiglottis cartilage and vocal folds.‌

The thyroid cartilage is wrapped around the front of your windpipe above your thyroid gland, and it's also connected to the cricoid cartilage. The movement between these cartilages helps you change the pitch of your voice.

Although it’s called “thyroid cartilage," the name comes from the Greek word thyreos, which means oval shield. The amount of thyroid cartilage you have doesn't decide how well your thyroid works.

What Decides the Size of the Adam’s Apple?

‌A size of the Adam’s apple is a secondary sexual characteristic— meaning that it shows up differently at puberty based on whether you are male or female. It is typically larger and more prominent in men, as it contains a larger voice box compared to that in women. Men develop a larger voice box than women during puberty.  So a larger Adam's apple may be linked to having a deep voice. 

In general, excessive hormones, mainly testosterone, produced at puberty decide the size of your Adam’s apple. A woman may have a larger Adam’s apple if she has high levels of testosterone, especially during puberty. The enlargement of the Adam's apple is often accompanied by other signs like an increase in acne and body hair and a deepened voice.

‌The angle at which your Adam’s apple is located around the voice box typically decides how much it will stand out. Women have a much wider angle, meaning that their Adam’s apple sits flush against the voice box, which leads to a less prominent Adam’s apple.

Surgery on the Adam’s Apple

There aren’t many medical reasons to have surgery on your Adam’s apple. In most cases, such surgery is used for cosmetic purposes. For example, a laryngeal shave — also known as a chondrolaryngoplasty — is a procedure used to lessen the size of your Adam’s apple. 

While laryngeal shave isn’t a major surgical procedure, you may need some recovery time. You’ll need to rest your voice as much as possible for the few days following surgery. Your surgeon may also advise that you avoid solid foods during this time.

On the other hand, you may want to make your Adam’s apple bigger. This is known as Adam’s apple augmentation and is generally performed by a plastic surgeon. It is needed because hormone therapy doesn’t always guarantee an increase in the size of your Adam’s apple. 

During the augmentation surgery, your surgeon will create an implant from your own cartilage — usually taken from your ribcage — and attach it to your thyroid cartilage in the neck. This will increase the size of your Adam’s apple and give you a more masculine appearance.

Another common Adam’s apple surgery is cartilage graft, which is used to treat windpipe defects in young children and infants. 

Show Sources

SOURCES:

Anatomy and Histology of the Laboratory Rat in Toxicology and Biomedical Research: “Thyroid Cartilage: An Overview."

BJOG: "Hyperandrogenemia in adolescent girls: origins of abnormal GnRH secretion." 

Fitzpatrick, T., Siccardi, M. Anatomy, Head and Neck, Adam’s Apple. StatPearls Publishing, 2020.

Flynn, W., Vickerton, P. Anatomy, Head and Neck, Larynx Cartilage. StatPearls Publishing, 2020.

International Journal of Pediatric Otorhinolaryngology: “Thyroid ala cartilage graft laryngotracheoplasty for closure of large pediatric tracheocutaneous fistula.”

Journal of the American Society of Plastic Surgeons: "First Female-to-Male Facial Confirmation Surgery with Description of a New Procedure for Masculinization of the Thyroid Cartilage (Adam's Apple)." 

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