Pathophysiology Microscopically, a focus of active otosclerosis reveals finger projections of disorganized bone, rich in osteocytes particularly at the leading edge. In the center of the focus, multinucleated osteocytes are often present. In the sclerotic phase,Pathophysiology ◼ Microscopically, a focus of active otosclerosis reveals finger projections of disorganized bone, rich in osteocytes particularly at the leading edge. In the center of the focus, multinucleated osteocytes are often present. In the sclerotic phase