Adam's apple

definition

"Adam's apple" is the name for the protruding and easily palpable section of the larynx in the middle of the neck, especially in men.For most men, the Adam's apple is easy to see at the front of the neck and moves up and down when swallowing and speaking. The Adam's apple is a thickening on the front of what is known as the thyroid cartilage, the largest cartilage in the larynx.

That the Adam's apple is more pronounced in men than in women is due to the different development during puberty. The male sex hormones in particular contribute to the formation of the Adam's apple. The development of the Adam's apple during puberty is associated with a change in the voice (voice break). Because behind the larynx are the vocal cords, which are elongated by the acute-angled forward growth of the Adam's apple. And since men get a deeper voice than women (up to an octave lower), their vocal cords have to be a lot longer.

Women also have an Adam's apple. However, it is a lot more inconspicuous with them and only about five to six millimeters thick. In men, the larynx grows by an additional six to seven millimeters due to the increased production of the hormone testosterone. So the cartilage becomes visible as an Adam's apple.

Naming

The term "Adam's apple" for the Larynx protrusion refers to the biblical account of the fall of Adam and Eve. Seduced by the snake, the curious Eve bit the forbidden fruit and Adam also tried it. This forbidden fruit The tree of knowledge is mostly depicted as an apple in medieval art. A popular belief says that Adam, because he had sinned, literally got stuck in Adam's throat as a punishment and as a result the man is now forever marked - with the "Adam's apple" on his neck. Up until the 19th century, the larynx protrusion was also referred to in medicine as "Pomum adami"which translates as Adam's apple. Nowadays the term is Latin "Prominentia laryngea" (Larynx protrusion) common.

Another explanation for the name of the Adam's apple can be found in the Hebrew language. The ancient Hebrew word for thyroid cartilage is also the word for apple. And since the Adam's apple is only visible in men, you have that Old Hebrew word for "man" taken in addition. In Hebrew, man means "Adam" - this is how the term Adam's apple may have come about.

Layout and function

The Adam's apple is a cartilaginous part of the larynx. The larynx separates the airways from the food passages. It protects the vocal cords and the entrance to the windpipe. The epiglottis (the epiglottis) closes the windpipe when swallowing, so that food and drinks can only travel through the esophagus into the stomach and cannot be "inhaled" through the windpipe and incorrectly end up in the lungs. If a foreign body is "inhaled", this is called "Aspiration" and that can lead to many complications, such as shortness of breath and infection. The front wall of the larynx is called the Thyroid cartilage educated. The vocal cords are also attached to the thyroid cartilage. These are set in vibration by air currents and thus make voice training possible. So when the larynx grows forward in men during puberty and forms the Adam's apple, the vocal cords grow along with it and this leads to Broken voice. As the length of the vocal cords roughly doubles (from about twelve millimeters to 2.2 centimeters), the voice becomes darker. That's why an adult's voice sounds deeper than that of a child. The vocal cords do not grow evenly, with some being shorter and others longer. That is why you can sometimes hear a "peep" in pubescent boys, jumping back and forth between the child's and the man's voice, the voice "breaking".

The Adam's apple is also one of the secondary sexual characteristics. these are gender characteristics, on the basis of which an individual can be assigned to the male or female gender. The secondary sexual characteristics develop during puberty. They signal that Puberty and complete the sexual appearance of men or women. Along with the Adam's apple and the broken voice, an increasing one also belongs in men body hair and the growth of beard too.

Diseases related to the Adam's apple

Diseases that affect the Larynx can affect, for example, malformations or tumors, such as the Throat cancer, a typical disease of smokers.

In addition, the larynx can be inflamed, especially if the respiratory tract is infected. The main symptom of a larynx disease is this hoarseness. But also difficulties swallowing and Shortness of breath can give an indication of such a disease and should be clarified by an ear, nose and throat specialist. In children, viral inflammation of the larynx must also be considered, the so-called Pseudo croup. The main symptom of croup is a barking and spasmodic cough, which occurs especially in the evening and causes severe shortness of breath when inhaled. The Adam's apple itself is extremely rarely affected by any disease.

If under the Adam's apple a larger one Swelling of the neck occurs, the possibility of thyroid disease should always be considered.
A thyroid goiter, for example, grows very slowly and is painless, which is why it is often discovered late.

examination

The larynx is very easy to use with the help of a Endoscope examine, e.g. with a bronchoscope or a pharyngeal endoscope. These are devices with which a Mirror optics or a video recording can be viewed "around the corner" through the mouth into the throat from above onto the vocal folds.

From the outside, the larynx can be examined well by feeling, especially the one Adam's apple can be checked for tenderness on pressure.

Feminization of the Adam's Apple (OP)

The Adam's apple is with humans differently pronounced. Some men have particularly prominent Adam's apples, others have one that is barely visible. There are also women who, due to their hormonal balance during puberty, have a very clearly visible Adam's apple on their necks. So there are a variety of sizes of Adam's apples in both sexes.

Since a particularly large and prominent Adam's apple causes problems for some people from an aesthetic point of view, there is now an operative option to grind the Adam's apple and thus make the shape more feminine.
This procedure is easy to perform, but it can weaken the structure of the larynx or permanently change the properties of the vocal cords. Therefore a feminization operation (Chondrolaryngoplasty) of the Adam's apple can only be carried out by an experienced surgeon and only if the patient's suffering is particularly great.

Adam's apple in women

The Adam's apple is a protruding part of the thyroid cartilage that forms the Larynx heard. It is present in both women and men. However, the Adam's apple develops depending on the human hormone balance. Since the "male hormone“ testosterone ensures greater growth, the Adam's apple is more pronounced in men than in women.

However, there are also women for whom the Adam's apple looks relatively large. This can be a Standard variant his or, in rare cases, through Disorders of the hormonal balance caused.
In women, a large Adam's apple can be too aesthetic problems lead, as this seems too masculine. This can lead to high levels of suffering. Women, whose Adam's apple seems too big to them, can hide it with a few tricks. For example, it can be concealed with a collar, a scarf or a scarf, or with a beautiful chain. Even with an open hairstyle you can get away with it neck distract.

In some cases, surgical reduction of the Adam's apple can also be considered (Chondrolaryngoplasty), whereby the indication for the operation should be made very cautious.
The thyroidwhich is located directly under the Adam's apple could also look like a large Adam's apple when magnified and should be examined for differential diagnosis.

injury

Minor injury on Adam's apple or on the windpipe usually need no treatmentbecause they heal on their own. Serious injuries can be caused by external trauma (e.g. knocking the edge of the hand) or a traffic accident to the larynx or trachea. This can lead to a potentially life-threatening narrowing of the airways. In the event of such an injury, the most important therapeutic measure is to ensure breathing, for example through a ventilation tube. The injury can then be treated surgically. Fortunately, such severe trachea injuries are rare.

Adam's throat pain

When there is pain in the Adam's apple, the larynx is often inflamed, which is why it is called laryngitis (laryngitis). It often occurs in the context of colds, in which the viruses move away from the primary infection site (Nose / throat) into the larynx. These are mainly caused by viruses and are associated with reddening of the mucous membrane in the throat. Common symptoms include excruciating coughs and hoarseness.
When the mucous membrane swells, the airways become narrowed so that breathing can be slightly impaired. If the sore throat occurs as part of a viral infection of the upper respiratory tract, it can be accompanied by a runny nose, cough and fever. Tension pain can be caused by swollen activated lymph nodes in the neck area.
The best therapy for a viral infection is to keep warm and rest. Walks in the fresh air also activate the immune system and are recommended. Sick people should refrain from smoking, as smoke also irritates the mucous membrane and delays healing. The symptoms can be relieved by warm drinks (Tea or milk) with honey, as this lubricates the throat. In general, you should drink a lot. Candies that stimulate the flow of saliva and lubricate the throat or have an anesthetic effect are similarly effective. Steam inhalations or gargles are often found pleasant. The inflammation usually subsides within a few days.
As a prophylactic, it is advisable to wear warm clothing during the winter months and to avoid close contact with sick people. The viruses spread through droplet infection, that is, through secretions and droplets that get into the air when you cough, for example.
The laryngitis can become chronic and lead to persistent weakness of the vocal cords with accompanying hoarseness. Therefore, if you have pronounced symptoms, you should definitely take care of your voice and consult a doctor. If the inflammation is due to a bacterial infection, the use of an antibiotic may be necessary.
Special care should be taken in children, as laryngitis can be acute and dangerous. When the mucous membrane swells in children, breathing can be severely impaired due to the narrow airways. So-called croup attacks often happen at night and are accompanied by a barking cough and hoarseness. Children between the ages of 1 and 5 are particularly affected. The pathogens are mostly viruses (Parainfluenza Viruses). The symptoms improve immediately in cold, fresh air, so that it helps to go out with the child in the fresh air and to calm them down. At the first pseudo croup attack or shortness of breath, a doctor should be consulted in any case, as the airways can swell so that the administration of cortisone or even artificial ventilation by means of intubation is necessary.
In contrast to the real croup (diphtheria), which hardly occurs in Germany due to the vaccination, the false croup / pseudokrupp (subglottic laryngitis) frequently.

Another rare differential diagnosis is inflammation of the epiglottis (epiglottitis) caused by the vaccination against Haemophilus influenza type B has also become very rare. In the very dangerous epiglottitis, there is usually no cough, but rather a lumpy language and severe difficulty swallowing. In addition, the general condition of the child is greatly reduced.

Tumors can also lead to pain through invasive growth by displacing other structures. These masses can also originate from the thyroid gland, which is located directly under the larynx. Pain caused by an inflammation of the thyroid gland can also be interpreted as originating from the Adam's apple due to its close proximity.
Smokers should consult an ear, nose and throat doctor immediately if they have persistent hoarseness for more than 2 weeks, swallowing difficulties and breathing problems, as they have a much higher risk of throat cancer.

Another rare cause can be neck cysts / fistulas. Neck cysts / fistulas are malformations that arise during embryonic development and can be filled with fluid. This is available as a median neck cyst (in the middle of the front of the neck) or as lateral (lateral) Neck fistula. If such a structure becomes infected, it can cause severe pain and difficulty swallowing. The median neck cyst is often discovered in childhood, the lateral neck fistula is often not noticed until adulthood. Fistulas have an opening to the surface of the skin from which secretions can drain. The median neck cyst can also develop a fistulous duct.
Both malformations from embryonic development can be surgically removed.

Read more on this topic at: Throat fistula

Removal of the Adam's apple

In the Chondrolaryngoplasty an approx. 2-3cm long incision is made in a skin fold, so that the scar is often hardly visible later. After exposing the thyroid cartilage, the upper parts of the thyroid cartilage are ground off. This reduces the extent of the protruding part of the Adam's apple.

So far, the operation has mainly been performed on transsexual women as part of a gender reassignment process.

It is mainly performed by plastic surgeons and has relatively low complication rates. Nevertheless, every operation is a risk and it should be carefully considered whether this is necessary. There are many on the neck Vessels and annoy run, they could be damaged.
In addition, breathing problems can occur after the operation; the voice is usually not changed after such an operation. However, if this is desired, the voice pitch can also be surgically changed in the same operation.
After the operation, a pressure bandage is applied and the pain is counteracted with cooling and medication.