We make the complexities of vestibular and facial therapy more understandable and applicable for the busy clinician.Â
Dr. Sara MacDowell, PT, DPT, AVPT
Dr. Sara MacDowell, PT, DPT is a physical therapist with over 16 years of specialized clinical experience treating patients with vestibular and facial nerve disorders. She practices at the Our Lady of the Lake Hearing and Balance Center in Louisiana, USA, a comprehensive neurotology clinic where she works alongside audiologists and neurotologists to care for patients with complex vestibular and facial conditions of various etiologies. Alongside her colleague, Dr. Laura Hetzler, she is one of the founding practitioners of the interdisciplinary Center for Facial Nerve Disorders.
Dr. MacDowell serves as an adjunct professor at Louisiana State University Health Sciences Center in New Orleans and is a board member and course instructor for vestibular lecture and lab at Franciscan University’s Doctor of Physical Therapy Program in Baton Rouge. She also assists with education through the otolaryngology residency program, teaching medical residents about vestibular rehabilitation. In addition, she serves as a clinical instructor and facilitates research through LSUHSC and Franciscan University. Her research collaborations have contributed to multiple journal publications related to vestibular and facial nerve disorders, with current areas of investigation including activity levels in patients with vestibular dysfunction, the use of virtual reality in vestibular rehabilitation, telehealth, and normative data in vestibular populations.
Dr. MacDowell earned her Doctor of Physical Therapy degree from Washington University in St. Louis in 2008. She has completed advanced training in vestibular rehabilitation, including the competency certifications Vestibular Rehabilitation and Vestibular Function Tests: Interpretation and Application to Rehabilitation, as well as the Advanced Vestibular Physical Therapist certification through the University of Pittsburgh. She has also completed mentorship and specialized training in facial nerve rehabilitation.
She has volunteered extensively with the APTA Vestibular Special Interest Group, contributing to content development, podcast programming, and conference organization. She also served as chairperson for the dissemination of the 2016 clinical practice guideline Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline. In the field of facial nerve rehabilitation, she is active in Facial Therapy Specialists International, where she has taught webinar content and served as a contributing author on a recently published international consensus paper among facial therapy experts. She was recently chosen to speak on an expert panel at the International Facial Nerve Symposium in September 2025 in Madrid, Spain.
Outside of her professional work, Sara and her husband Adam have been married for 15 years and enjoy raising their two children, along with a cuddly dog and several chickens.
Dr. Sydney Duhe, PT, DPT, AVPT
Dr. Sydney Duhe, PT, DPTÂ is a physical therapist with over ten years of clinical experience treating patients with vestibular disorders. She practices at the Our Lady of the Lake Hearing and Balance Center in Louisiana, USA, a comprehensive neurotology clinic where she works alongside audiologists and neurotologists to evaluate and treat patients with vestibular disorders of various etiologies. Her clinical interests include the intersection of vestibular and orthopedic conditions, particularly cervical spine contributions to dizziness, headache, and otalgia. Prior to specializing in vestibular rehabilitation, Dr. Duhe gained clinical experience in orthopedic and acute care settings, which continues to inform her approach to complex dizziness presentations.
Dr. Duhe serves as an adjunct professor at Louisiana State University Health Sciences Center (LSUHSC) in New Orleans, where she contributes to instruction in vestibular rehabilitation within the physical therapy curriculum. She is also a course instructor for the vestibular lecture and lab at Franciscan University’s Doctor of Physical Therapy Program in Baton Rouge. In addition, she facilitates research collaborations through LSUHSC and Franciscan University. Her research interests include activity levels in patients with vestibular dysfunction, the use of virtual reality in vestibular rehabilitation, telehealth, normative data in vestibular populations, and the prevalence of cervical spine disability among individuals with vestibular disorders.
Within her hospital system, Dr. Duhe works closely with acute care physical therapists to improve vestibular education and advocate for early identification and treatment of patients with dizziness and vestibular dysfunction in the hospital setting.
Dr. Duhe earned her Doctor of Physical Therapy degree from LSUHSC in New Orleans in 2016. She has completed competency certifications in Vestibular Rehabilitation and Cervicogenic Dizziness, and in 2025 she completed the Advanced Vestibular Physical Therapist (AVPT) certification through the University of Pittsburgh. She is also certified in functional dry needling. Throughout her career she has been an active member of the American Physical Therapy Association (APTA) and the Vestibular Special Interest Group, previously serving as the Social Media Chair for the Vestibular SIG.
Outside of her professional work, Sydney and her husband Steven have been married for ten years and enjoy raising their three young children.
Research
Wellons RD, Duhe SE, MacDowell SG, Oxborough S, Madhav KC. Investigating health disparities in vestibular rehabilitation. J Vestib Res. 2024 May 11. doi: 10.3233/VES-240002. Epub ahead of print. PMID: 38759079.
Neville C, Beurskens C, Diels J, MacDowell S, Rankin S. Consensus Among International Facial Therapy Experts for the Management of Adults with Unilateral Facial Palsy: A Two-Stage Nominal Group and Delphi Study. Facial Plast Surg Aesthet Med. 2023 Nov 3. doi: 10.1089/fpsam.2023.0101. Epub ahead of print. PMID: 37922418.
Hetzler L, MacDowell S, Diels J, Vandewater T, Azzizadeh B. Chemodenervation Algorithm: functional and aesthetic considerations for facial harmony in patients with post-facial paralysis synkinesis. Facial Plast Surg Aesthed Med. 2023. Online ahead of print.Â
Hetzler L, Hershey M, Lambert T, Mussell J, McDaniel L, MacDowell S. Anatomic Considerations of Perinasal Musculature for Improved Dental Show During Smile in Facial Synkinesis. Facial Plast Surg Aesthet Med. 2022;24:89-94.
Warrington S, MacDowell S, Hetzler L. Facial Nerve Consultation. Chapter in Management of Post-Facial Paralysis Synkinesis. Elsevier. 2022; 25-31.
Wellons R, Duhe S, MacDowell S, Diaz G, Poche C, Johnson M, Steen B. Validation of the StepWatch activity monitor in individuals with vestibular disorders. Physiother Theory Pract. 2021;37:1060-1066.
Erbele I, MacDowell S, Arriaga M. Can Dizziness Handicap Inventory and Activities-Specific Balance Confidence Scores Assess Vestibular Loss After Vestibular Schwannoma Excision? Otol Neurotol. 2020; 41(10).
Erbele I, MacDowell S, Arriaga M. Preoperative Caloric Testing is a Poor Predictor of Postoperative Dizziness. Virtual poster presentation at Combined Otolaryngology Spring Meeting. May 2020.
Wellons R, Duhe S, MacDowell S, Diaz G, Poche C, Johnson M, Steen M. Validation of the StepWatch activity monitor in individuals with Vestibular Disorders. Physiother Theor Pr. 2019.
Hetzler L, MacDowell S, Trahan J, Arriaga M, McDaniel LS. Facial Nerve Translocation for Low Tension Neurorrhaphy to Masseteric Nerve. Otol Neurotol. 2019; 40(5).
Wellons R, MacDowell S, Duhe S. Impact of Vestibular Rehabilitation on Physical Activity of Individuals with Vestibular Disorders. Poster presentation at Combined Sections Meeting of the American Physical Therapy Association January 2019.
Martinez C, MacDowell S, Dannenbaum L, D’Silva L, Farrell L, Roth H, Skop K, Howard, R, Tilson J. Implementing the APTA Clinical Practice Guidelines for Peripheral Vestibular Hypofunction: Preliminary Results of Multicenter Mixed Methods Case Series. Poster presentation at Combined Sections Meeting of the American Physical Therapy Association January 2019.
Tilson J, MacDowell S, Dannenbaum L, D’Silva L, Farrell L, Roth H, Skop K. A Model for Active Dissemination and Implementation of Clinical Practice Guidelines Published by Academies and Sections of the APTA. Poster presentation at Combined Sections Meeting of the American Physical Therapy Association February 2018.
MacDowell S, Wellons R, Bissell A, Knecht L, Naquin C, Karpinski A. The Impact of Symptoms of anxiety and depression on subjective and objective outcome measures in individuals with vestibular disorders. J Vestib Res. 2018; 27(5-6):295-303.
MacDowell S, Trommelen R, Karpinski A, Bissell A, Knecht L, Naquin C. The Impact of Anxiety and Depression on Subjective and Objective Outcome Measures on Patients with Vestibular Dysfunction. Poster presented at Combined Sections Meeting of the American Physical Therapy Association February 2016.
 MacDowel S, Arriaga MA. The Negative Effect of Unsupervised Exercises on Patients with Facial Paresis. Poster presented at American Academy of Otolaryngology September 2014.
MacDowell S, Trommelen R, Allen S, Sehrt E, Stancliffe T. The effect of an Optokinetic Stimulation DVD with educational material on symptoms experienced by individuals with visual vertigo: A case series. 2013.
The Story Behind ANTE
Back in 2009, while working in an inpatient stroke rehab unit, one of my patient’s had vestibular symptoms and I felt unprepared to provide her adequate treatment. I started reading as much as I could and found a mentor to guide me through treating her. After that patient had excellent results, I was completely fascinated by the vestibular system and started learning as much as I could. A few years later, I went to Emory University to complete the “Vestibular Competency” course and absolutely loved being immersed in the world of vestibular therapy. I subsequently became the lead therapist for an outpatient vestibular rehab program in St. Louis, MO. After years of learning as much as possible and taking every advanced course I could, I developed my own continuing education course and traveled around the country to teach. I loved meeting therapists from all over and really loved teaching. I found that the feedback was pretty much the same everywhere, people felt like they finally understood, like something clicked. I absolutely loved helping therapists gain that confidence. In 2012 my husband and I decided to move back to my hometown, Baton Rouge, LA. I was fortunate to be able to join an interdisciplinary team in a large neuro-otology practice. I have loved the challenge of working in a bustling tertiary care center, but I realized that I truly missed teaching. So, in 2019, I launched Advanced Neuro Therapy Education with the goal of teaching local therapists about the vestibular system. I recently realized that I want to reach even more therapists and offer more content. I was fortunate to have a colleague who shares my same passion and so I brought Sydney Duhe onto the team. We are excited to see what this new phase of ANTE can offer!
