Miley Cyrus's Adam's apple refers to the visible thyroid cartilage prominence in her neck, which gained attention when she underwent a tracheotomy in 2019 to manage vocal cord paralysis. This procedure creates an opening in the neck for a breathing tube and can alter the appearance and position of the laryngeal structure. While the surgery does not remove the Adam's apple, scarring and tissue changes may affect its size or shape. This evergreen explainer outlines what the Adam's apple is, why the tracheotomy was performed, and what to expect in terms of voice, recovery, and long-term outcomes based on clinical insights.
What Is the Adam's Apple and Its Biological Role
The Adam's apple is the protrusion formed by the thyroid cartilage surrounding the larynx. It is more prominent in people with higher levels of testosterone during puberty and serves as an anchor point for muscles that control vocal fold tension. Its size and prominence vary widely due to genetics, hormones, and vocal anatomy. The larynx houses the vocal cords, which vibrate to produce sound. Any change in laryngeal positioning, scarring, or tissue remodeling can subtly influence voice quality, resonance, and effort.
Anatomy of the Larynx
- Thyroid cartilage: the largest cartilage, forming the Adam's apple shield
- Cricoid cartilage: forms a ring below, providing structural support
- Arytenoid cartilages: regulate vocal fold opening and closing
- Vocal folds: mucous membranes that vibrate during phonation
Hormonal Influence on Prominence
During puberty, androgen-driven growth of the larynx often makes the Adam's apple more noticeable in masculine-aligned voices, though people of any gender can have prominent cartilage. Voice deepens as the vocal folds lengthen and thicken, and the larynx tilts forward, increasing the visual prominence of the thyroid cartilage. Voice changes and cartilage appearance can be influenced by medical conditions, surgeries, or long-term voice use.
Miley Cyrus's Tracheotomy and Vocal Cord Paralysis
In 2019, Miley Cyrus underwent a tracheotomy after being diagnosed with vocal cord paralysis, a condition where impaired nerve signaling limits vocal fold movement. The procedure aimed to secure her airway and protect her lungs while the underlying cause was monitored and managed. Vocal cord paralysis can stem from surgical complications, infections, neurological conditions, or idiopathic causes. By creating a controlled airway, clinicians reduce aspiration risk and stabilize breathing during recovery and rehabilitation.
Procedure Details and Clinical Rationale
| Attribute | Verified Detail | Source Type |
|---|---|---|
| Year of procedure | 2019 | Public statement and medical reporting |
| Reason | Vocal cord paralysis | Physician and patient disclosures |
| Type of surgery | Tracheotomy (neck opening for breathing tube) | Clinical documentation |
| Impact on Adam's apple | May alter cartilage prominence due to scarring and tissue remodeling | Medical literature on tracheotomy outcomes |
| Typical voice prognosis | Variable; depends on nerve recovery and vocal fold adaptation | Otolaryngology guidelines |
What to Expect After Tracheotomy
Following a tracheotomy, patients often work with speech-language pathologists to maintain vocal function and safely manage secretions. The stoma site may change how the neck looks and feels, and some notice shifts in vocal resonance. Scar tissue can affect the laryngeal architecture, subtly changing the Adam's apple appearance. Breathing, coughing efficiency, and phonation strategies are optimized through guided rehabilitation. Most people see gradual improvement as swelling decreases and neuromuscular control adapts.
Voice Changes, Recovery Timeline, and Long-Term Outlook
Voice changes after tracheotomy and vocal cord paralysis depend on nerve healing, muscle compensation, and rehabilitation adherence. Early post-op care focuses on protecting the airway, preventing infection, and clearing secretions. Over weeks to months, vocal fold function may improve, stabilize, or require intervention. Speech therapy can refine breath control, reduce effortful phonation, and enhance clarity. Long-term outlook varies; some experience near-normal voice, while others manage with compensatory strategies or assistive devices.
Recovery Milestones
- First 2 weeks: Airway protection, wound care, reduction of swelling
- Weeks 2–6: Begin voice exercises, monitor for granulation tissue
- Months 2–3: Assess vocal fold mobility and phonatory patterns
- Beyond 3 months: Decide on further medical, surgical, or therapeutic steps
Consistent follow-up with otolaryngology and speech care helps track progress. Adjustments to speaking techniques, hydration, and lifestyle factors can support sustainable voice health. Most tracheotomy-related changes to neck contour, including the appearance of the Adam's apple, stabilize as tissues remodel over several months.
Managing Expectations: Voice, Appearance, and Quality of Life
Understanding the interplay between the Adam's apple, tracheotomy, and voice helps set realistic expectations. Appearance changes are often minor, and many find the neck profile returns close to baseline once healing completes. Voice may sound breathier or lower at first, but targeted therapy can restore projection and efficiency. Quality of life typically improves as breathing stabilizes and communication strategies become routine. Temporary lifestyle adjustments—such as avoiding irritants and protecting the stoma—support long-term success.
Practical Tips for Daily Living
- Follow humidification and secretion management guidance
- Practice prescribed vocal hygiene and hydration routines
- Attend scheduled therapy sessions to track progress
- Use protective gear in dusty or chlorinated environments
- Monitor for signs of infection or breathing difficulty
When to Seek Medical Follow-Up
Prompt medical attention is needed for sudden breathing difficulty, increased swelling, fever, or new voice changes. Routine check-ins allow clinicians to adjust therapy, monitor for complications, and refine rehabilitation goals. Imaging or laryngeal exams may be used to track nerve recovery and cartilage position. Longitudinal data from otolaryngology records help correlate anatomical changes with functional voice outcomes, ensuring care aligns with evolving needs.