Center for Minimally-invasive Surgery of the Nose, the Sinuses and the anterior Skull Base

  • Diagnosis


    Symptoms and history
    are important.

    Individualized counselling and diagnostic management
    ensure an adequate treatment policy for each patient
    on an individual basis

  • Allergy


    25-30% of the population in western industrial
    societies suffer from allergies.

    Our long experience with allergy diseases enable us
    to provide you with dhe adequate diagnostic
    measures and treatment.

  • Nasal Airway Obstruction

    Nasal Airway Obstruction

    Nasal airway obstruction has a significant
    negative impact on patient's lives

    We have been involved with diseases of the nose and
    paranasal sinuses for almost 30 years and can therefore
    recommend the adequate therapeutic approach for diseases.

  • About the operation

    About the operation

    About 1/3 of the population
    suffers from snoring

    Our experience with different aspects of sleep medicine
    lasts more than 15 years. Our goals are making an exact diagnosis
    with screening and - if necessary - sleep laboratory evaluation and
    then advise you on legitimate therapeutic approaches.

  • Chronic rhinosinusitis

    Chronic rhinosinusitis

    Surgical procedures in the head are regarded
    as particularly dangerous by many patients.

    After thousands of pre-operative counselling sessions we know
    that operations in the head and neck area are considered as extremly
    dangerous by the patients. Therefore trust and safety are the top priorities of our work

  • Snoring


    About 1/3 of inflammatory sinus
    diseases become chronic.

    We have been involved in research and diagnostic management
    of nasal and paranasal sinus diseases for more than 25 years.
    This long experience enables us to give you adequate advice
    on how to treat those kinds of diseases.

Monday - Friday:
08.00 – 12.00h
14.00 – 16.30h

Prinzenweg 1
82319 Starnberg

How to find us

Diagnostic Approach to Diseases of the Nose and Sinuses

An exact diagnosis is essential before starting appropriate and individualized therapy. Depending on the history and symptoms, a variety of diagnostic measures may be employed. The following examinations should be performed in virtually every patient with complaints relating to the nose or sinuses:

  1. Endoscopic examination of the nose. After administration of a nasal spray for local anesthesia and decongestion. A thin, high-intensity fiber optic endoscope is introduced into the nose. The entire nasal cavity can be examined including the nasal septumturbinates and nasopharynx (posterior region of nasal cavity). In addition, the mucosa can be well visualized. This technique is the best way to completely evaluate the anatomical features inside the nose.
  2. Rhinomanometry. This test measures the pressure difference between the nostrils and nasopharynx and the amount of air passing through the nose. It should be performed before every operation in order to quantitate the degree of nasal airway obstruction. The test is also an essential part of quality control and should be repeated a few weeks after the operation, especially if the surgical approach has not brought the anticipated clinical improvement. Comparing the pre- and post-operative values allows one to document the success or relative failure of an operation.
  3. Allergy testing. Nasal airway obstruction can have many causes. Enlargement of the inferior turbinates is one of the most common reasons for this problem; in many instances an allergic diseaseof the nose is the underlying cause for the swelling.
    A simple series of skin tests (prick tests) identify over 90% of the allergens (allergic triggers) which are likely to cause allergic rhinitis. This test allows one for all practical purposes to exclude allergic rhinitis or identify its likely causes. In the instances where this simple and convenient test does not give the needed information, additional allergy tests can be performed. When an allergy test is positive-depending on the symptoms-most often a non-operative therapy is sufficient to reduce or eliminate the patient’s complaints.
  4. Smell test. A variety of substances are held in front of each nostril separately before and after decongestion of the nasal mucosa. This test today is usually done using standardized test kits (such as Sniffin Sticks); they provide well-standarized results. The smell test is a key part of the evaluation of all nasal diseases. It is essential when the patient complains of a reduced or even absent sense of smell, which is often the case for patients with nasal polyps.
  5. Imaging. Modern imaging techniques are essential in the diagnosis of chronic rhinosinusitis and nasal polyps. Cone beam Computed tomography (CBCT) or Computerized tomography (CT scan) are the method of choice for visualizing the fine bony structures which separate the sinuses from the orbit or other sensitive areas of the skull. The exact images of bones forming the boundaries of the sinuses are required by the surgeon as he or she plans an operative approach to correct sinus disease. Excellent imaging makes it possible to operate with the greatest safety, avoiding vital structures which could potentially be damaged (Therapeutic approach to chronic rhinosinusitis and nasal polyps).Conventional X-ray images are not precise enough and even magnetic resonance imaging is not ideal for analyzing these essential structures.

Cone Beam Computed Tomography (CBCT)

Besides the patient‘s history, symptoms and physical examination, imaging procederes are yet another mainstay of the diagnostic management in chronic inflammatory sinus disease, particularly if surgery is intended. Imaging techniques provide information about the positional relationships between the paranasal sinuses and the surrounding structures, i.e the eyes and anterior skull base, which are mandatory for planning surgery and the patient‘s safety.

There are basically two imaging techniques , which are eligible to address this problem. Since the 80s of the last century, computed tomography was the only available procedure with radition exposure being a major drawback. Over the last years Cone Beam Computed Tomography (CBCT) has evolved as a new technique which combines excellent image quality with significant lower radiation exposure.

In our clinic we operate a CBCT of the youngest generation to supply our patients with currently the most updated technology available.



Do you have any further questions?

Our team will be happy to answer your questions.

Phone: +49 8151 – 3013


Publications by Prof. Grevers

  • Basic Otorhinolaryngology: A Step-by-Step Learning Guide

    Basic Otorhinolaryngology: A Step-by-Step Learning Guide, Second Edition, is an accessible introduction to the core concepts and potentially complex interrelationships in otorhinolaryngology and head and neck surgery. The fully revised new edition includes latest developments and up-to-date terminology, up-to-date diagnostic and treatment methods, and succinct overviews of important international consensus documents and position papers in the field. The book presents material in an engaging and user-friendly format, with chapters divided into study units that follow a consistent structure. Readers will also find a wealth of figures, tables, and flowcharts to facilitate quick comprehension of topics.

    Basic Otorhinolaryngology: A Step-by-Step Learning Guide
    G.Grevers, M.Röcken: Taschenatlas Allergologie. Thieme Verlag, 2. Auflage 2008
  • Taschenatlas Allergologie: Grundlagen - Diagnostik - Klinik

    Komprimiert und doch verständlich: Allergologie auf aktuellem Stand
    Fachübergreifende Komplettdarstellung - Kompetenz in allen Fachgebieten
    Optimale Visualisierung komplexer Zusammenhänge
    Bewährtes Schema: kompakter Textteil - übersichtliche Farbtafeln
    Handbuchwissen im Taschenbuch-Format
    ausführlicher Anhang mit wichtigen Testsubstanzen, Allergenen, Reizstoffen, Glossar u.v.m.

    Taschenatlas Allergologie: Grundlagen - Diagnostik - Klinik
    G.Grevers, M.Röcken: Taschenatlas Allergologie. Thieme Verlag, 2. Auflage 2008
  • VIdeo 2

    Interview mit Springer Medizin
    Datum: Frühjahr 2014