The mesotympanum can be approached by the two well known approaches, i.e. (1) the (per meatal) tympanotomy, by lifting the posterior annulus tympanicus and (2) the posterior tymanotomy, via the facial recess. Based on surgical experience of 1113 cases, this paper describes in detail the advantages, uses, limitations, possible complications, etc., of an (as yet) anonymous approach to the middle ear i.e. approaching the middle ear by lifting the anterior annulus tympanicus. The paper recommends a possible new nomenclature so as to avoid confusion in our understanding of the terminology.