Histopathological examination of an actively progressing otosclerotic focus would show:
- A Highly vascular, hypercellular spongy bone with osteoclastic resorption and widened perivascular spaces staining basophilically (blue mantles of Manasse) ✓
- B Avascular, densely sclerotic lamellar bone with osteoblastic rimming
- C Replacement of the endochondral layer by compact ivory-like bone containing cholesterol clefts
- D Granulation tissue with hemosiderin-laden macrophages filling the oval window niche
Correct answer: A. Highly vascular, hypercellular spongy bone with osteoclastic resorption and widened perivascular spaces staining basophilically (blue mantles of Manasse)
Explanation
In the active phase, called otospongiosis, osteoclasts resorb bone and replace it with immature woven bone rich in vascular marrow spaces, giving the focus its spongy, hypervascular appearance. Widened perivascular spaces take up basic dyes and form the blue mantles of Manasse. Mature burnt-out foci instead become sclerotic and avascular, so option B describes the inactive phase. Cholesterol granulomas belong to chronic middle ear effusion, not otosclerosis.
Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.