Charles Alfred Ballance
Encyclopedia
Charles Alfred Ballance was an English surgeon
who specialized in the fields of otology
and neurotology
. For much of his professional life he was associated with St. Thomas' Hospital and National Hospital, Queen Square
in London. He was the first president of the Society of British Neurological Surgeons, and was a colleague of famed surgeon Victor Horsley
(1857–1916).
Ballance is remembered for his pioneer work involving nerve grafting
and neurologic
surgery. He is credited as being the first physician to perform a facial nerve
to spinal accessory nerve anastomosis
for treatment of facial palsy
. He also did the first operation for complete removal of a cerebellopontine angle
tumor
, as well as being one of the first surgeons to perform a radical mastoidectomy with ligation
of the jugular vein
. Ballance is also remembered for successfully sectioning the vestibulocochlear nerve
(cranial nerve VIII) as a remedy for intractable vertigo
.
Ballance published over 75 articles during his career, his best known work being the 1919 Essays on the Surgery of the Temporal bone
. Later in life he was knighted as "Sir Charles Alfred Ballance" for his many contributions made in medicine.
In 1933, he was awarded the Lister Medal, and gave the associated Lister Memorial Lecture. The lecture was titled 'On Nerve Surgery'. It was published in 1933, dedicated "To the Memory of A.C.B.", his son Alaric Charles Ballance, who had died in February of that year. The book includes details of Ballance's work at three laboratories: the National Institute for Medical Research
in Hampstead, the laboratories of the Royal College of Surgeons of England
, and the 'Laurelwood Laboratory' in the USA. The latter was a laboratory established at Laurelwood, the country residence of Arthur Baldwin Duel, near Pawling, New York.
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
who specialized in the fields of otology
Otology
Otology is a branch of biomedicine which studies normal and pathological anatomy and physiology of the ear as well as its diseases, diagnosis and treatment....
and neurotology
Neurotology
Neurotology or neuro-otology is a branch of clinical medicine which studies and treats neurological disorders of the ear. It is a subspecialty of otolaryngology, and is closely related to otology. Neurotologists are physicians who have specialised in otolaryngology, but who have further...
. For much of his professional life he was associated with St. Thomas' Hospital and National Hospital, Queen Square
National Hospital for Neurology and Neurosurgery
The National Hospital for Neurology and Neurosurgery is a neurological hospital in London, United Kingdom and part of the University College London Hospitals NHS Foundation Trust...
in London. He was the first president of the Society of British Neurological Surgeons, and was a colleague of famed surgeon Victor Horsley
Victor Horsley
Sir Victor Alexander Haden Horsley was an accomplished scientist and professor. He was born in Kensington, London. He was educated at Cranbrook School, Kent and studied medicine at University College London and in Berlin, Germany , and in the same year started his career as a house surgeon and...
(1857–1916).
Ballance is remembered for his pioneer work involving nerve grafting
Medical grafting
Grafting refers to a surgical procedure to move tissue from one site to another on the body, or from another person, without bringing its own blood supply with it. Instead, a new blood supply grows in after it is placed. A similar technique where tissue is transferred with the blood supply intact...
and neurologic
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
surgery. He is credited as being the first physician to perform a facial nerve
Facial nerve
The facial nerve is the seventh of twelve paired cranial nerves. It emerges from the brainstem between the pons and the medulla, and controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue and oral cavity...
to spinal accessory nerve anastomosis
Anastomosis
An anastomosis is the reconnection of two streams that previously branched out, such as blood vessels or leaf veins. The term is used in medicine, biology, mycology and geology....
for treatment of facial palsy
Palsy
In medicine, palsy is the paralysis of a body part, often accompanied by loss of sensation and by uncontrolled body movements, such as shaking. Medical conditions involving palsy include cerebral palsy , brachial palsy , and Bell's palsy ....
. He also did the first operation for complete removal of a cerebellopontine angle
Cerebellopontine angle
The cerebellopontine angle is a structure at the margin of the cerebellum and pons.Breast cancer can metastasize to the cerebellopontine angle.It can be a site for lipoma.It is where acoustic neuromas are usually found.-External links:...
tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
, as well as being one of the first surgeons to perform a radical mastoidectomy with ligation
Ligation
Ligation may refer to:* In molecular biology, the covalent linking of two ends of DNA molecules using DNA ligase* In medicine, the making of a ligature * Chemical ligation, the production of peptides from amino acids...
of the jugular vein
Jugular vein
The jugular veins are veins that bring deoxygenated blood from the head back to the heart via the superior vena cava.-Internal and external:There are two sets of jugular veins: external and internal....
. Ballance is also remembered for successfully sectioning the vestibulocochlear nerve
Vestibulocochlear nerve
The vestibulocochlear nerve is the eighth of twelve cranial nerves, and is responsible for transmitting sound and equilibrium information from the inner ear to the brain...
(cranial nerve VIII) as a remedy for intractable vertigo
Vertigo (medical)
Vertigo is a type of dizziness, where there is a feeling of motion when one is stationary. The symptoms are due to a dysfunction of the vestibular system in the inner ear...
.
Ballance published over 75 articles during his career, his best known work being the 1919 Essays on the Surgery of the Temporal bone
Temporal bone
The temporal bones are situated at the sides and base of the skull, and lateral to the temporal lobes of the cerebrum.The temporal bone supports that part of the face known as the temple.-Parts:The temporal bone consists of four parts:* Squama temporalis...
. Later in life he was knighted as "Sir Charles Alfred Ballance" for his many contributions made in medicine.
In 1933, he was awarded the Lister Medal, and gave the associated Lister Memorial Lecture. The lecture was titled 'On Nerve Surgery'. It was published in 1933, dedicated "To the Memory of A.C.B.", his son Alaric Charles Ballance, who had died in February of that year. The book includes details of Ballance's work at three laboratories: the National Institute for Medical Research
National Institute for Medical Research
The National Institute for Medical Research, commonly abbreviated to NIMR, is a medical research facility situated in Mill Hill, on the outskirts of London, England. It is mainly funded by the Medical Research Council, or MRC, and is its largest establishment and the only one designated as an...
in Hampstead, the laboratories of the Royal College of Surgeons of England
Royal College of Surgeons of England
The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...
, and the 'Laurelwood Laboratory' in the USA. The latter was a laboratory established at Laurelwood, the country residence of Arthur Baldwin Duel, near Pawling, New York.
Associated eponym
- Ballance's signBallance's signDuring trauma assessment of the abdomen, "Ballance's sign" may be observed upon exam.Ballance's sign is dullness to percussion in the left flank LUQ and shifting dullness to percussion in the right flank seen with splenic rupture/hematoma....
: Fixed dullness in the left flank, and shifting dullness in the right flank while the patient is lying on his left side. Associated with rupture of the spleenSpleenThe spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...
in abdominal trauma.