Adam's apple

{{more medical citations needed|section|date=February 2022}}

The topographic structure which is externally visible and colloquially called the "Adam's apple" is caused by an anatomical structure of the thyroid cartilage called the laryngeal prominence or laryngeal protuberance protruding and forming a "bump" under the skin at the front of the throat. All human beings with a normal anatomy have a laryngeal protuberance of the thyroid cartilage. This prominence is typically larger and more externally noticeable in adult males. There are two reasons for this phenomenon. Firstly, the structural size of the thyroid cartilage in males tends to increase during puberty,{{cite web|url=http://www.medicineonline.com/dictionary/Prominentia-laryngea.html |title=Prominentia laryngea |publisher=Medicine Online |access-date=2013-02-27 |url-status=dead |archive-url=https://web.archive.org/web/20131225120054/http://www.medicineonline.com/dictionary/Prominentia-laryngea.html |archive-date=2013-12-25 }} and the laryngeal protuberance becomes more anteriorly focused. Secondly, the larynx, which the thyroid cartilage partially envelops, increases in size in male subjects during adolescence, moving the thyroid cartilage and its laryngeal protuberance towards the front of the neck. The adolescent development of both the larynx and the thyroid cartilage in males occurs as a result of hormonal changes, especially the normal increase in testosterone production in adolescent males. In females, the laryngeal protuberance sits on the upper edge of the thyroid cartilage, and the larynx tends to be smaller in size, and so the "bump" caused by protrusion of the laryngeal protuberance is much less visible or not discernible.{{cite web|url=http://sisbib.unmsm.edu.pe/bibvirtual/libros/medicina/cirugia/tomo_v/laringe.htm |title=Laringe |publisher=Sisbib.unmsm.edu.pe |access-date=2013-02-27}} Even so, many women display an externally visible protrusion of the thyroid cartilage, an "Adam's apple", to varying degrees which are usually minor, and this should not normally be viewed as a medical disorder.

The Adam's apple, in relation with the thyroid cartilage which forms it, helps protect the walls and the frontal part of the larynx, including the vocal cords (which are located directly behind it).{{Cite web |date=2022-04-27 |title=Adam's Apple Reduction vs. Voice Feminization — Facialteam |url=https://facialteam.eu/blog/adams-apple-reduction-voice-feminization-surgery/ |access-date=2023-04-13 |language=en-US}}

Another function of the Adam's apple is related to the deepening of the voice. During adolescence, the thyroid cartilage grows together with the larynx. Consequently, the laryngeal prominence grows in size, mainly in men. Together, a larger soundboard is made up in phonation apparatus and, as a result, men get a deeper voice note.P. J. Bentley (1980), "Endocrine Pharmacology: Physiological Basis and Therapeutic Applications", CUP Archive, pág 240{{cite web|url=http://www.esmas.com/salud/home/conocetucuerpo/365349.html |archive-url=https://web.archive.org/web/20040908143335/http://www.esmas.com/salud/home/conocetucuerpo/365349.html |url-status=dead |archive-date=2004-09-08 |title=Pubertad, nuestras diferencias |publisher=Esmas.com |access-date=2013-02-27 }}

File:Cross_section_of_thyroid_cartilage_before_and_after_laryngoplasty_at_9.11.34_PM.png (FemLar) surgical technique using a top-down horizontal cross section of the larynx. The area labeled "front" in each image is the Adam's Apple/Laryngeal Prominence. In a tracheal shave, superficial tissue at the front of the larynx is dissected and the general shape of the larynx's interior, along with the underlying vocal cords, are otherwise unaffected. In feminization laryngoplasty, the Adam's Apple is moved back even further by modifying the underlying vocal cords as well, and the voice and interior of the larynx are also affected.]]

While both men and women can possess an Adam's apple, the larger frequency of its appearance in men has led to the perception of the Adam's apple as an indicator of masculinity. As such, transgender women may choose to undergo cosmetic surgery to remove it from their necks, a process known as chondrolaryngoplasty, or colloquially as a "tracheal shave".{{Cite web |title=UCLA surgeons develop new technique to reduce Adam's apple without neck scar |url=https://newsroom.ucla.edu/releases/surgery-removes-adams-apple-without-scar |access-date=2023-01-02 |website=UCLA |language=en-US}} Transgender men may choose to augment and thereby enlarge the Adam's apple, a process known as masculinization.{{Cite journal |last1=Deschamps-Braly |first1=Jordan C. |last2=Sacher |first2=Caitlin L. |last3=Fick |first3=Jennifer |last4=Ousterhout |first4=Douglas K. |date=April 2017 |title=First Female-to-Male Facial Confirmation Surgery with Description of a New Procedure for Masculinization of the Thyroid Cartilage (Adam's Apple) |url=https://pubmed.ncbi.nlm.nih.gov/28350659/ |journal=Plastic and Reconstructive Surgery |volume=139 |issue=4 |pages=883e–887e |doi=10.1097/PRS.0000000000003185 |issn=1529-4242 |pmid=28350659|s2cid=25766890 }}

Chondrolaryngoplasty surgery is effective, and studies done by surgeons in Tel Aviv and Los Angeles have demonstrated complications to be few and, if present, transient.{{cite journal |vauthors =Wolfort FG, Dejerine ES, Ramos DJ, Parry RG |title=Chondrolaryngoplasty for appearance |journal=Plast. Reconstr. Surg. |volume=86 |issue=3 |pages=464–9; discussion 470 |year=1990 |pmid=2385664 |doi=10.1097/00006534-199009000-00012}}{{Cite magazine |title=How a New Scarless Surgery Could Affect Transgender Patients |url=https://time.com/5603828/transgender-scarless-adams-apple-surgery/ |access-date=2023-01-02 |magazine=Time |language=en}}

There is also an additional surgery available, feminization laryngoplasty, also known as "FemLar", which can safely reduce the Adam’s Apple to an extent greater than that which can be accomplished by a tracheal shave, given it explicitly operates on the vocal cords within the Adam's apple as opposed to avoiding them. However, feminization laryngoplasty is a reconstructive surgery that carries additional risks and has a very strong feminizing effect on the voice that may or may not be desirable to the patient.{{cite journal |last1=Kim |first1=Hyung-Tae |title=Vocal Feminization for Transgender Women: Current Strategies and Patient Perspectives |journal=International Journal of General Medicine |date=2020 |volume=13 |pages=43–52 |publisher=NIH |doi=10.2147/IJGM.S205102 |pmid=32104050 |pmc=7024865 |doi-access=free }}{{cite journal |last1=Thomas |first1=James Philip |title=Feminization Laryngoplasty - A Comprehensive Approach to Reducing the Size of the Larynx and Pharynx |url=https://pubmed.ncbi.nlm.nih.gov/35750518/ |journal=Otolaryngologic Clinics of North America |date=2022 |volume=55 |issue=4 |pages=739–748 |publisher=NIH |doi=10.1016/j.otc.2022.05.002 |pmid=35750518 |s2cid=249934885 |access-date=2 September 2023}}{{cite web |last1=Thomas |first1=James Philip |title=Feminization Laryngoplasty - Surgical Creation of a Feminine Voice |url=https://www.voicedoctor.net/system/files/2022-11/FemLar%20handout%202022-11.pdf |website=VoxDoc |publisher=James Philip Thomas |access-date=2 September 2023}} There are also far fewer practitioners who are known to be currently performing FemLar as it is far newer than the tracheal shave procedure.

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The English term "Adam's apple" is a calque of Latin {{Lang|la|pomum Adami}}, which is found in European medical texts from as early as 1600.{{cite book|title=Historia Anatomica Humani Corporis|first=André|last=du Laurens|location=Paris|year=1600|url=https://archive.org/details/BIUSante_00276/page/n539/mode/2up|page=510|quote=Huius supreme pars βρόγχος, quibusdam vulgò morsus & pomum Adami appelatur.}} "Adam's Apple" is found in a 1662 English translation of Thomas Bartholin's 1651 work Anatomia.{{cite book|year=1662|translator-last1=Culpeper|translator-first1=Nicholas|translator-last2=Cole|translator-first2=Abdiah|title=Bartholinus Anatomy|url=https://archive.org/details/b30333696/page/122/mode/2up?|publisher=Peter Cole|location=London|page=123|quote=That same bunch which is seen on the foreside of the Neck, is called Adams Apple, because the common people have a belief, that by the judgment of God, a part of that fatal Apple, abode sticking in Adams Throat, and is so communicated to his posterity|trans-quote=Protuberantia illa in collo anterius conspicua, dicitur Pomum Adami; [quia vulgo persuasum in Adami faucibus pomi fatalis partem ex pœna Divina remansisse, & ad posteros translatam]|first=Thomas|last=Bartholin|orig-year=1651}}

The 1662 citation includes an explanation for the origin of the phrase: a piece of forbidden fruit was supposedly embedded in the throat of Adam, who according to the Abrahamic religions was the first man: {{blockquote|the common people have a belief, that by the judgment of God, a part of that fatal Apple, abode sticking in Adams Throat, and is so communicated to his posterity}} This etymology is also proposed by Brewer's Dictionary of Phrase and Fable and the 1913 edition of Webster's Dictionary.E. Cobham Brewer (1810–1897). Dictionary of Phrase and Fable. 1898. "Adam's Apple" The story is not found in the Bible or other Jewish, Christian, or Islamic writings.George Crabb (1823), "Universal technological dictionary", Baldwin, Cradock, and Joy, "Pomum Ada'mi"

Linguist Alexander Gode proposed in 1968 that the Latin phrase {{Lang|la|pomum Adami}} (literally: 'Adam's apple') was a mistranslation of the Hebrew "{{Lang|he-Latn|tappuach ha adam}}", meaning "male bump".{{cite journal |first=Alexander |last=Gode |title=Just Words |journal=JAMA |date=1968-10-28 |page=1058 |volume=206 |issue=5 |doi=10.1001/jama.1968.03150050046009 |url=https://jamanetwork.com/journals/jama/article-abstract/341605|url-access=subscription }} The confusion was supposedly due to the fact that in the Hebrew language the proper name "Adam" ({{Lang|he|אדם}}) literally means "man", and the word for "apple", "tapuach", is similar to the word "{{Lang|he-Latn|tafuach}}" which means "swollen", thus in combination: the swelling of a man.William S. Haubrich (2003), "Medical Meanings: A Glossary of Word Origins", ACP Press, pág 5.{{cite web|url=http://medicine.academic.ru/155/Adam's_apple|title=Adam's apple |publisher=Medicine.academic.ru|access-date=2013-02-27}}

The medical term "prominentia laryngea" (laryngeal prominence) was introduced by the Basle Nomina Anatomica in 1895.Axel Karenberg, Amor, Äskulap & Co.: klassische Mythologie in der Sprache der modernen Medizin, Schattauer, Stuttgart 2006, S. 128-129.

In the American South, "goozle" is used colloquially to describe the laryngeal prominence, likely derived from guzzle.{{cite web|last1=Morris|first1=Evan|title=Goozle « The Word Detective|url=http://www.word-detective.com/2008/11/goozle/|website=The Word Detective|access-date=22 December 2014|date=November 2008|quote=If we follow 'goozle' back a bit further, we come to an interesting intersection with a far more common word, 'guzzle.'}}{{cite book|author =Roy Blount Jr.|title=Alphabet Juice: The Energies, Gists, and Spirits of Letters, Words, and Combinations Thereof; Their Roots, Bones, Innards, Piths, Pips, and Secret Parts, Tinctures, Tonics, and Essences; With Examples of Their Usage Foul and Savory|url=https://books.google.com/books?id=xZWKctOqg8YC&pg=PT162|date=29 September 2009|publisher=Farrar, Straus and Giroux|isbn=978-1-4299-6042-7|quote=The Dictionary of Smoky Mountain English defines google (or goozle) as 'the throat, Adam's apple.'}}{{cite book|author=Roy Wilder|title=You All Spoken Here|url=https://books.google.com/books?id=xw8eLjzXH4IC&pg=PA55|date=1 September 1998|publisher=University of Georgia Press|isbn=978-0-8203-2029-8|page=55|quote=Adam's apple; goozle; the projection formed by the thyroid cartilage in the neck.}}{{cite web|title=Goozle|url=https://www.daredictionary.com/view/dare/ID_00024696|website=Dictionary of American Regional English|publisher=Harvard College|access-date=28 November 2020|quote=The throat as a whole, or spec the gullet, windpipe, or Adam’s apple. chiefly South, South Midland}}

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• Hyoid bone

{{Reflist}}

{{Commons category}}

• [https://web.archive.org/web/20101014175716/http://www.wesnorman.com/Lesson11.htm Lesson 11] at The Anatomy Lesson by Wesley Norman (Georgetown University)

{{Human regional anatomy}}

{{Larynx anatomy}}

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Category:Adam and Eve

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Category:Eponyms in medicine

Category:Human head and neck

Category:Secondary sexual characteristics