About

Joseph P. Roche is an Associate Professor and the Chief of the Division of Otology and Neurotology at the Department of Otolaryngology-Head and Neck Surgery at the University of Wisconsin–Madison. He holds an MD from the Medical College of Wisconsin and completed his residency at the University of North Carolina at Chapel Hill. Dr. Roche further specialized through a fellowship in Otology, Neurotology, and Lateral Skull Base Surgery at the University of Iowa Hospitals and Clinics. He is double board certified by the American Board of Otolaryngology in General Otolaryngology and Neurotology. His clinical specialties include otolaryngology, otology, neurotology, and lateral skull base surgery, and he is actively involved in research within these fields.

Research topics

• Audiology
• Medicine
• Radiology
• Communication
• Pathology
• Surgery
• Psychology

Selected publications

• Spatial separation enhances speech intelligibility but increases listening effort with session-dependent variability in pupillometric measures

  Frontiers in Neuroscience · 2025-11-10

  articleOpen access

  Introduction: The current understanding of the cognitive load of listening effort has been advanced by combining speech intelligibility and pupillometry measures. However, the reliability of pupil dilation metrics in complex listening scenarios like spatial release from masking (SRM) remains uncertain. This study investigated how spatial separation of sound sources impacts listening effort (via peak pupil dilation, PPD) and speech intelligibility. Methods: Speech intelligibility and listening effort were simultaneously measured under co-located and symmetric, spatially-separated conditions at varying signal-to-noise ratios (SNRs). Results: Results showed that although spatial separation improved speech intelligibility, it did not yield a corresponding reduction in listening effort. Instead, listening effort increased as SNR became more challenging. Furthermore, test-retest reliability was moderate-to-high for speech intelligibility but only moderate-to-low for PPD, with greater consistency observed at more challenging SNRs. These results suggest that obtaining stable PPD measures within an SRM paradigm may be difficult to achieve. Discussion: These findings indicate that obtaining stable PPD measures within an SRM paradigm can be challenging. Test session reliability is weak when combining SRM paradigms with measures of listening effort, which may reduce statistical power due to factors such as sample size, number of trials, and sessions tested. This is further limited by the relatively small and homogeneous sample of young, typical hearing adults. Future studies should include a larger and more diverse participant group to assess the generalizability of these results. Clinical trial registration: The study was registered on September 21, 2024, with the identifier number NCT02532972.

  PublisherOA PDFDOI

• Gross Total Resection of Multicompartmental Chondrosarcoma Through Combined Transcavernous and Anterior Transpetrosal Approaches With Endoscopic Assistance: 2-Dimensional Operative Video

  Operative Neurosurgery · 2024-10-30

  article
  PublisherDOI

• Efficacy of Cochlear Implantation in Neurofibromatosis Type 2 Related Hearing Loss

  Annals of Otology Rhinology & Laryngology · 2022 · 5 citations

  Senior authorCorresponding
  • Medicine
  • Audiology
  • Surgery

  OBJECTIVE: To investigate the results of cochlear implantation in subjects with neurofibromatosis type 2 (NF2) and bilateral vestibular schwannomas (VS). STUDY DESIGN: Retrospective case series. SETTING: University-based tertiary referral center. SUBJECTS: Five subjects with NF2 and severe-to-profound sensorineural hearing loss. INTERVENTION: Cochlear implantation. MAIN OUTCOME MEASURE: Surgical outcomes and audiometric performance after cochlear implantation. RESULTS: Five subjects (3 female, 2 male) were included in the study. The mean age at the time of implantation was 54 years old (range 35-78 years). Follow-up after cochlear implantation averaged 38 months (range 21-106 months). In the 5 implanted ears, 2 had no prior treatment, 1 had undergone prior radiation therapy, 1 underwent prior microsurgical removal, and 1 underwent prior microsurgical removal with adjuvant radiation therapy. The mean ipsilateral VS dimensions at time of implantation were 14 mm × 7.2 mm × 6.1 mm (mediolateral × anteroposterior × craniocaudal). Following cochlear implant activation, all 5 subjects achieved sound awareness, open set speech recognition, and 4 continue to be daily users of the devices. CONCLUSION: Cochlear implantation is a viable hearing rehabilitation option for subjects with NF2 and severe-to-profound sensorineural hearing loss. All subjects reported benefit with their cochlear implant, including open set speech recognition, enhanced lip-reading skills and environmental awareness of sound. Four subjects continued to demonstrate improved open-set speech recognition at the time of their last evaluations.

  PublisherDOI

• Systematic Comparison of Trial Exclusion Criteria for Pupillometry Data Analysis in Individuals With Single-Sided Deafness and Normal Hearing

  Trends in Hearing · 2021 · 13 citations

  • Audiology
  • Psychology
  • Medicine

  The measurement of pupil dilation has become a common way to assess listening effort. Pupillometry data are subject to artifacts, requiring highly contaminated data to be discarded from analysis. It is unknown how trial exclusion criteria impact experimental results. The present study examined the effect of a common exclusion criterion, percentage of blinks, on speech intelligibility and pupil dilation measures in 9 participants with single-sided deafness (SSD) and 20 participants with normal hearing. Participants listened to and repeated sentences in quiet or with speech maskers. Pupillometry trials were processed using three levels of blink exclusion criteria: 15%, 30%, and 45%. These percentages reflect a threshold for missing data points in a trial, where trials that exceed the threshold are excluded from analysis. Results indicated that pupil dilation was significantly greater and intelligibility was significantly lower in the masker compared with the quiet condition for both groups. Across-group comparisons revealed that speech intelligibility in the SSD group decreased significantly more than the normal hearing group from quiet to masker conditions, but the change in pupil dilation was similar for both groups. There was no effect of blink criteria on speech intelligibility or pupil dilation results for either group. However, the total percentage of blinks in the masker condition was significantly greater than in the quiet condition for the SSD group, which is consistent with previous studies that have found a relationship between blinking and task difficulty. This association should be carefully considered in future experiments using pupillometry to gauge listening effort.

  PublisherOA PDFDOI

• Adult Onset Bilateral Cochlear Nerve Atrophy and Cochlear Implantation: A Case Report and Review of the Literature

  Annals of Otology Rhinology & Laryngology · 2021 · 1 citations

  Senior authorCorresponding
  • Medicine
  • Audiology
  • Radiology

  OBJECTIVE: To describe a case of idiopathic bilateral cochlear nerve atrophy acquired in adulthood. PATIENT: A 75-year-old male with acquired bilateral cochlear nerve atrophy. INTERVENTION(S): Unilateral cochlear implantation. MAIN OUTCOME AND RESULTS: Description of a patient with acquired bilateral cochlear nerve atrophy diagnosed at the age of 75. The patient had normal hearing and no communication deficits until the age of 66. At this point, the patient demonstrated a slight asymmetric hearing loss, which progressed to severe sensorineural hearing loss. Due to the resulting communication deficit, cochlear device implantation candidacy was pursued. Pre-operative magnetic resonance imaging (MRI) showed severe atrophy versus absence of the cochlear nerves bilaterally. After careful counseling regarding the expected communication outcomes given the MRI findings, the patient underwent left-sided cochlear implantation. The patient gained sound awareness, but no additional communication benefit compared to pre-operative baseline abilities. CONCLUSION: Cochlear nerve deficiency is a known finding in certain cases of congenital and acquired hearing loss, but no cases of idiopathic adult-onset bilateral nerve atrophy have been reported. Without MR imaging, the clinically significant finding would not have been identified. Thus, MRI is advantageous when compared with other imaging modalities in patients with progressive sensorineural hearing loss and enables improved patient counseling regarding expected auditory and communication outcomes.

  PublisherDOI

• Intraoperative Electrocochleographic Characteristics of Auditory Neuropathy Spectrum Disorder in Cochlear Implant Subjects

  UNC Libraries · 2020-04-16

  articleOpen access

  Auditory neuropathy spectrum disorder (ANSD) is characterized by an apparent discrepancy between measures of cochlear and neural function based on auditory brainstem response (ABR) testing. Clinical indicators of ANSD are a present cochlear microphonic (CM) with small or absent wave V. Many identified ANSD patients have speech impairment severe enough that cochlear implantation (CI) is indicated. To better understand the cochleae identified with ANSD that lead to a CI, we performed intraoperative round window electrocochleography (ECochG) to tone bursts in children (n = 167) and adults (n = 163). Magnitudes of the responses to tones of different frequencies were summed to measure the “total response” (ECochG-TR), a metric often dominated by hair cell activity, and auditory nerve activity was estimated visually from the compound action potential (CAP) and auditory nerve neurophonic (ANN) as a ranked “Nerve Score”. Subjects identified as ANSD (45 ears in children, 3 in adults) had higher values of ECochG-TR than adult and pediatric subjects also receiving CIs not identified as ANSD. However, nerve scores of the ANSD group were similar to the other cohorts, although dominated by the ANN to low frequencies more than in the non-ANSD groups. To high frequencies, the common morphology of ANSD cases was a large CM and summating potential, and small or absent CAP. Common morphologies in other groups were either only a CM, or a combination of CM and CAP. These results indicate that responses to high frequencies, derived primarily from hair cells, are the main source of the CM used to evaluate ANSD in the clinical setting. However, the clinical tests do not capture the wide range of neural activity seen to low frequency sounds.

  PublisherDOI

• Imaging Characteristics of Children With Auditory Neuropathy Spectrum Disorder

  UNC Libraries · 2020-11-07

  articleOpen access

  To identify and define the imaging characteristics of children with auditory neuropathy spectrum disorder (ANSD).

  PublisherDOI

• A Gerbil Model of Sloping Sensorineural Hearing Loss

  UNC Libraries · 2020-11-07

  articleOpen access

  The goal of the overall project is to develop knowledge about cochlear physiology during cochlear implantation and develop procedures for assessing its status during hearing preservation surgery. As a step toward this goal, for this study, we established an animal model of sloping high frequency sensorineural hearing loss that mimics the hearing condition of candidates for combined electric-acoustic stimulation.

  PublisherDOI

• Vestibular Schwannoma Surgery

  2019-01-01 · 3 citations

  bookSenior author
  PublisherDOI

• Vestibular Schwannoma Surgery: A Video Guide

  2019-01-01 · 1 citations

  book1st authorCorresponding
  Publisher

Frequent coauthors

• Marlan R. Hansen

  University of Iowa

  15 shared

• Bruce J. Gantz

  University of Iowa Hospitals and Clinics

  13 shared

• Rick F. Nelson

  University School

  10 shared

• Sima Sayyahmelli

  Neurological Surgery

  10 shared

• Mustafa K. Başkaya

  University of Wisconsin–Madison

  9 shared

• Craig A. Buchman

  Washington University in St. Louis

  8 shared

• Christy B. Erbe

  Medical College of Wisconsin

  7 shared

• Paul Popper

  J. Paul Getty Museum

  7 shared