In the clinical routine, the diagnostic of the lateral gait is often comparable with a complete peripheral vestibular function examination. Diseases of the otolithic organs, with the saccule and utricle are not identified with conventional clinical examination methods. In more than 50% of patients with thermal hypostimulation, orientation tests show a simultaneous pathology of the utricle function. Participation of the saccule has been described for vestibular neuropathy, Menière’s disease, bilateral vestibulopathy and acoustic neurinoma. Both otolithic organs are included in posttraumatic vertigo, a recognition, which will influence expert opinions in the future. Only by an exact diagnostic of diseases of the otolithic organs can individual disease courses be differential diagnostically separated from each other.