Larynx (Voice Box)

What is the larynx (voice box)?

Your larynx is part of your respiratory system. It’s a hollow tube that’s about 4 to 5 centimeters (cm) in length and width. It lets air pass from your throat (pharynx) to your trachea on the way to your lungs. Your larynx is also the reason you’re able to make sounds, so it’s often called your voice box.

What is the function of the larynx?

Your larynx helps you to:

• Breathe. When you take in air through your nose and mouth, your larynx funnels it down to your trachea and to your lungs.
• Talk, shout and make other vocal sounds. Your larynx contains your vocal cords, which create sound.

Where is my larynx located?

Your larynx is in the middle of your neck, just above your trachea (windpipe) and your esophagus. But its exact location changes throughout your life.

From birth up until age 2, your larynx was higher in your neck. Over time, your larynx moves down to the middle of your neck.

What are the parts of my larynx?

Your larynx is divided into three parts:

• The upper part (supraglottis).
• The middle part (glottis).
• The lower part (subglottis).

Your supraglottis, glottis and subglottis have different types of cartilage, muscle, ligaments and membranes, but only your glottis contains your vocal folds (vocal cords):

• Cartilages in your larynx help to give it structure, the same way interior walls frame a house.
• Muscles in your larynx move your larynx while swallowing, help with breathing and produce vocal sounds.
• Ligaments in your larynx connect cartilages and link your larynx to nearby structures, like your hyoid bone and trachea.
• Membranes help to hold cartilage in place.

What are conditions and disorders that affect my larynx?

Many things can affect your larynx, from diseases like cancer to simply using your voice too much. Conditions that affect your larynx include:

• Acute laryngitis: You may develop acute laryngitis if you have an infection or if you strain your vocal cords by overusing your voice.
• Chronic laryngitis: Long-term laryngitis lasts longer than three weeks. Causes include smoking, allergies and reflux.
• Laryngeal cancer: You can develop cancer in any part of your larynx.
• Trauma or injury: You can hurt your larynx by overusing your voice when speaking, shouting or singing for a long time. Likewise, being hit in your throat can hurt your larynx.
• Vocal cord dysfunction: This occurs when the vocal cords don’t act or work normally.
• Vocal cord lesions: This happens when you develop noncancerous lesions, nodules, polyps or cysts, especially with overuse of your voice.
• Vocal cord paralysis: This happens when one or both vocal cords don’t move properly.

What are common symptoms of conditions that affect the larynx?

Some common symptoms are:

• Sore throat or cough.
• Voice changes, including hoarseness.
• Pain or other difficulties when you swallow.

Talk to your healthcare provider if you’ve had these symptoms for more than two weeks.

What are common tests to diagnose larynx issues?

Tests will vary depending on the suspected cause, but may include:

• Throat culture or blood tests to check for infections.
• Imaging tests like magnetic resonance imaging (MRI), computed tomography (CT) scan or positron emission tomography (PET) scan.
• Videostroboscopy to examine your vocal cords while they’re vibrating.
• Laryngoscopy to examine your larynx.
• Biopsy to remove tissue for examination under a microscope.

What are common treatments for larynx issues?

Acute and chronic laryngitis

• Antibiotics.
• Antifungals.

Laryngeal cancer

• Radiation therapy.
• Chemotherapy.
• Immunotherapy.
• Targeted therapy.
• Laryngectomy.

Vocal cord dysfunction

Treatment depends on your situation but could include:

• Breathing exercises.
• Speech therapy.
• Heliox (a combination of oxygen and helium).
• Tracheostomy. A provider may do this procedure if vocal cord dysfunction keeps air from getting to your lungs.

Vocal cord lesions

Treatment depends on the underlying cause but may include:

• Voice therapy.
• Help with lifestyle changes that may reduce your risk of vocal cord lesions.
• Surgery.

Vocal cord paralysis

• Voice therapy.
• Vocal cord injection to place filler in vocal cord gaps.
• Laryngeal framework surgery to insert a voice box implant.
• Tracheostomy if vocal fold paralysis affects breathing.

How do I take care of my larynx?

There are lots of ways to take care of your larynx and your voice, including:

• Reduce your risk of laryngeal cancer: Avoid tobacco products and secondhand smoke. Limit the number of beverages containing alcohol that you drink.
• Reduce your risk of laryngitis: Protect yourself against respiratory infections by washing your hands and avoiding people who are sick. Drink lots of water to keep your throat from feeling dry.
• Protect your vocal cords: Don’t strain your voice. Limit chemicals and medications that can dry your vocal cords, like some over-the-counter (OTC) cold and allergy medications.

When should I call my healthcare provider?

Several conditions can affect your larynx. You should contact your provider if you have symptoms that don’t go away after treatment or get worse.

Can someone talk without a larynx?

They can, but they’d have to learn new ways to speak and communicate. For example, some people who have surgery to remove their larynx may use an electrolarynx. An electrolarynx is an artificial larynx that you hold against your throat to make your speech clearer.