Are there muscles in the larynx (voice box)?

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Yes, the Larynx Contains Multiple Muscles

Yes, the larynx contains both intrinsic and extrinsic muscles that are essential for voice production, breathing, and airway protection. 1, 2, 3

Intrinsic Laryngeal Muscles

The intrinsic laryngeal muscles are specialized striated muscles located within the larynx itself that control vocal cord movement and tension:

  • All intrinsic laryngeal muscles except the cricothyroid receive motor innervation from the recurrent laryngeal nerve (RLN). 1, 2

  • The cricothyroid muscle is the sole exception, receiving innervation from the external branch of the superior laryngeal nerve. 4

  • These muscles are bilaterally arranged and functionally grouped as adductors and abductors of the glottis and tensors of the vocal cords. 4

  • The posterior cricoarytenoid muscle is the primary muscle that opens the laryngeal airway, while the cricothyroid works together with it to accentuate this opening. 3

  • The thyroarytenoid/lateral cricoarytenoid complex represents key intrinsic muscles commonly examined during laryngeal electromyography. 1

Extrinsic Laryngeal Muscles

Extrinsic muscles connect the larynx to surrounding structures and control laryngeal position:

  • Opening muscles include the geniohyoid, mylohyoid, sternothyroid, and middle constrictor. 3

  • Closing muscles include the thyrohyoid, cricothyroid, sternohyoid, and inferior constrictor. 3

  • The suprahyoid muscles play a critical role in swallowing by elevating the larynx and opening the upper esophageal sphincter. 1

Additional Laryngeal Musculature

  • The cricopharyngeus muscle receives motor innervation from the RLN and is positioned posterior to the thyroid gland adjacent to the esophagus. 5, 2

  • The inferior constrictor also receives innervation from the RLN. 2

Clinical Significance

  • Motor neurons controlling intrinsic laryngeal muscles are located in the nucleus ambiguus in the medulla. 1, 4

  • Laryngeal motor fibers within the RLN have a 4 to 1 adductor to abductor ratio. 2

  • These muscles contain a greater percentage of type 1 (slow-twitch) fibers compared to limb skeletal muscles, reflecting their specialized function for sustained phonation and airway control. 4

  • Dysfunction of laryngeal muscles can occur in conditions such as vocal cord paralysis, spasmodic dysphonia, Parkinson disease, and muscular tension dysphonia. 1, 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Recurrent Laryngeal Nerve Injury and Its Clinical Implications

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Opening and closing mechanisms of the larynx.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 1984

Research

[Anesthesia and laryngeal muscle, especially intrinsic laryngeal muscles].

Masui. The Japanese journal of anesthesiology, 1993

Guideline

Cricopharyngeus Muscle Anatomy and Identification

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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