Vocal cord paralysis significantly impairs the quality of life of those affected. Unilateral paresis primarily causes glottal closure insufficiency, weak voice, and hoarseness. Bilateral paresis, on the other hand, impairs breathing and limits physical capacity. For over a hundred years, various biomaterials have been used to treat unilateral vocal cord paralysis, including tissue transfer, injection materials, implants, and nerve transfer. According to current scientific findings, early augmentation can reduce the need for later invasive treatment and speed up the patient's voice rehabilitation. In cases of bilateral paralysis, laser resection is currently the most common treatment for glottal enlargement, but this requires a trade-off between improved breathing and preserved voice quality. In the future, laryngeal pacemakers and selective reinnervation could restore vocal fold function in a targeted manner, thereby significantly improving quality of life.