It is characteristic of adolescent children that when their voices change, a bulge appears in the middle of their necks, which they already have for life. Although it has always been believed otherwise, women also have it, although smaller. This nut is also known as ‘bite or Adam’s apple’, alluding to the episode of the Original Sin of Genesis in which Adam suffers how a piece of forbidden fruit gets stuck in his throat.
Dr. Teresa Rivera, head of the Otolaryngology Service at the Príncipe de Asturias University Hospital in Madrid, specifies that it is “the cervical prominence formed by the union of the two layers of thyroid cartilage, which produces a perceptible relief below the skin in the central area of the neck”. As she indicates, this bulge it is “variable”, being larger in adult males. “In these it is both visible and palpable, while it is much smaller in women, who also have it but are less evident and bulging,” says the expert.
Specifically, the ‘Adam’s apple’ or “visible prominence of the Thyroid cartilage”, ands the largest of the cartilages of the larynx. It begins to be observable in males during puberty (between the ages of 11 and 15), conditioning the changes that arise in the voice at this stage. “Both sheets of the thyroid cartilage have a quadrangular shape (wings) and the point of union between them forms an acute angle that is usually less than 90 degrees in men, while in women this angle is more open and reaches 110 – 120 degrees. That’s why it’s less prominent,” he adds.
According to Rivera, it is composed of specialized and flexible cartilaginous tissue, which generally involves cartilage cells or chondrocytes, collagen fibers, and the perichondrium (tissue layer) as the surrounding layer of cartilage. Its function –he adds_is the protection of vital structures for phonation, especially the vocal cords; it also provides the structure and armor of the larynx.
Bigger nut, deeper voice
The vocal cords are in direct and close anatomical and functional relationship with the cartilage Thyroid; the progressive increase in size of the cartilage conditions an elongation and thickening of the vocal cords, all this in response to the hormonal changes (testosterone) generated during puberty.
“The larger the strings, the more serious the voice is. Thus, in the case of men it is related to testosterone, which produces an enlargement of that Adam’s apple, but in the case of women, with estrogens (the main hormone) this does not happen, they do not enlarge that apple. That is why men have a larger larynx and it makes the voice deeper. Within men, there are also genetic factors of body size related to the hornomal load that varies depending on the man”, clarifies the specialist in Otorhinolaryngology.
Regarding whether the walnut can be broken, what happens, Rivera indicates that due to trauma, or due to attacks with a knife, traffic accidents. “With a neck injury that affects the thyroid cartilage and the larynx, it can happen, although we don’t see it very frequently”apostille.
Finally, the otorhinolaryngologist points out that generally the walnut is not operated for aesthetics, only in sex changes can surgeries be performed to reduce their size and feminize the voice. “That can be done. Through sex change interventions when the transsexual patient wants that aspect, it can also feminize the voice. In this case, the size of the cartilage of the larynx is shortened,” she concludes.