Our prior work suggested that petro-occipital fissure (POF) ossification may be altered in clinicopathologies of the cranial base such as hearing loss (Balboni et al., 2005). Here we demonstrate an accelerated and statistically significant ossification of the POF and cochlear aqueduct (CA) in a historical population of patients diagnosed with tuberculosis (TB). While a number of studies have sought to reduce the importance of the POF/CA to hearing, given its anatomical location, evolutionary conservation across mammals and the mounting data linking morphological changes of the POF/CA to the temporal onset of hearing loss and tinnitus, it is becoming difficult to maintain that its function is not related to inner ear homeostasis. Anat Rec, 291:488–490, 2008. © 2008 Wiley-Liss, Inc.