are often used to produce deep sonorous tones in Tibetan chant and Tuvan throat singing, as well as in musical screaming and the death growl vocal style. Microanatomy The vocal cords are composed of twin infoldings of 3 distinct tissues: an outer layer of flat cells that do not produce keratin (squamous epithelium). Below this is the superficial layer of the lamina propria, a gel-like layer, which allows the vocal fold to vibrate and produce sound. The vocalis and thyroarytenoid muscles make up the deepest portion. These vocal folds are covered with a mucous membrane and are stretched horizontally, from back to front, across the larynx. Variation Males and females have different vocal fold sizes. Adult male voices are usually lower-pitched due to longer and thicker folds. The male's vocal folds are between 1.75 cm and 2.5 cm (approx 0.75" to 1.0") in length, while females' vocal folds are between 1.25 cm and 1.75 cm (approx 0.5" to 0.75") in length. The vocal folds of children are much shorter than those of adult males and females. The difference in vocal fold length and thickness between males and females causes a difference in vocal pitch. Additionally, genetic factors cause variations between members of the same sex, with males' and females' voices being categorized into voice types. Development In newborns Newborns have a uniform single layered lamina propria, which appears loose with no vocal ligament. The monolayered lamina propria is composed of ground substances such as hyaluronic acid and fibronectin, fibroblasts, elastic fibers, and collagenous fibers. While the fibrous components are sparse, making the lamina propria structure loose, the hyaluronic acid (HA) content is high. HA is a bulky, negatively charged glycosaminoglycan, whose strong affinity with water procures hyaluronic acid its viscoelastic and shock absorbing properties essential to vocal biomechanics. Viscosity and elasticity are critical to voice production. Chan, Gray and Titze, quantified the effect of hyaluronic acid on both the viscosity and the elasticity of vocal folds by comparing the properties of tissues with and without HA. The results showed that removal of hyaluronic acid decreased the stiffness of the vocal cords by an average of 35%, but increased their dynamic viscosity by an average of 70% at frequencies higher than 1 Hz. Newborns have been shown to cry an average of 6.7 hours per day during the first 3 months, with a sustained pitch of 400–600 Hz, and a mean