Top musicians and young aspirants seek the help of voice clinics to preserve their voices and for optimum performance.For a Carnatic vocalist in Chennai, Margazhi is truly a bit of both — the best and the worst. The best because Margazhi offers the ultimate public platform for a performance, and the worst, because despite what it delivers, Margazhi is the chilliest part of Chennai that otherwise ranges between hot and hottest. The climate brings along with it a host of ear-nose-throat infections all of which definitely have an impact on a singer's voice and consequently performance. Voice clinics are just about entering the vocabulary of Carnatic music, with top musicians and students making their acquaintance with the speech pathologist/laryngologist mostly to rescue them from a bad throat on the eve of a kutcheri, but also, increasingly these days, to conserve the voice and optimise performance.``The concept of a voice clinic is like have a physiotherapist for the sports team," says ENT surgeon and Managing Director, Madras ENT Research Foundation. MERF's voice clinic set up five years ago sees as many as a 100 patients from all over the country every week, not only singers, but also professional voice users such as politicians and teachers. ``Voice production is a muscular activity," he explains. ``We call singers voice athletes," says Prakash Bhoominathan, Assistant Professor, department of speech and hearing, Sri Ramachandra Medical College and Research Institute. Singers use the muscles of their throat, vocal, sometimes stomach and regulate breathing, just as much as athletes use the muscles of the legs and arms. Dr. Kameswaran also explains that voice could be abused in three ways: over use, shouting, or using voice in the wrong pitch. Each of these could lead to bleeding and the formation of nodules and polyps on the vocal cords - altering the natural timbre of the voice and compromising on a singer's repertoire. ``With any of these conditions, a singer could be comfortable at the lower pitches, but not with a high pitch. In the early stages, this problem is reversible, but later it requires surgery and at the end of it, the voice might not sound the same again." Prevention, as the saying goes, is better than cure, Dr. Bhoominathan says. A fact endorsed by Dr. Kameswaran. That, in fact, is the concept of a voice clinic - to tend to healthy voices in their prime and ensure they remain so. Having trained in the U.K., he has himself looked down the throats of opera singers, who in the peak of their performance, are examined periodically by professionals and advised rest if there are any signs of stress or strain in the voice.Something an experienced ENT surgeon can detect even listening to the voice of the singer. But for those who cannot, there are a whole array of sophisticated diagnostic tools. The prince of which is a stroboscope, which produces in slow motion, a videograph of the movement of the vocal cords. Vocal cords have to be slowed down dramatically to be studied. ``This is a very sensitive way of picking up a problem at its earliest stage." This tool is also effective in noticing structural deficiencies in the cords of young singers - deficiencies that cannot be remedied. ``In these cases, we recommend that the person take up playing a musical instrument," Dr. Kameswaran says. Often voice clinics are besieged with singers, just hours before the performance, suffering from throat infections and seeking quick solutions. ``While we have to examine what exactly caused the problem, it is also important to provide interim solutions," Mr. Bhoominathan says. ``It is true that treating a singer with steroids can restore the voice sufficiently to perform a two-hour kutcheri, but we do not advise it," Dr. Kameswaran says. Primarily because of the side effects that it can cause. It is also not advisable to keep abusing the voice just to seek out a temporary fast cure in time for a performance. The doctor also sees a big role for sabhas in promoting the vocal health of its singers every year, by organising awareness programmes or commissioning voice tests annually.