Abstract: The purpose of this 4-part series is to illustrate the nuances of temporal bone anatomy using a high-resolution (200 μ isotropic) prototype volume computed tomography (CT) scanner. The normal anatomy in axial and coronal sections is depicted in the first and second parts. In this, the fourth part, and the third part, the structures that are removed and/or altered in 9 different surgical procedures are color coded and inscribed in the same coronal (article IV) and axial (article III) sections. The text stresses clinically important imaging features, including the normal postoperative appearance, and common complications after these operations. The superior resolution of the volume CT images is vital to the comprehensive and accurate representation of these operations. Minuscule intricate structures that are currently only localized in the mind's eye because of the resolution limit of conventional CT are clearly seen on these scans. This enhanced visualization, together with the information presented in the text, should assist in interpreting temporal bone scans, communicating with surgeons, and teaching this complex anatomy.