The main adverse effect of vocal fold enlargement surgery is difficulty in vocalization, and some patients may suffer from aspiration. Vocal fold enlargement surgery is mainly applied to the treatment of bilateral laryngeal nerve paralysis and bilateral vocal fold paralysis, and its therapeutic purpose and principle is to relieve the obstruction of the respiratory tract and preserve the function of phonation as far as possible. Currently, more surgical treatments are carried out in the clinic, including arytenoid chondroplasty by extralaryngeal or intralaryngeal route, arytenoid chondroplasty by CO₂ laser or posterior end of the vocal folds, and arytenoid chondroplasty by plasma radiofrequency. All of these methods are performed at the expense of articulation and are also prone to aspiration. Vocal cord paralysis should be observed for at least 6 months before any surgical treatment that alters the laryngeal structure, and for vagus nerve injury, skull base injury, and idiopathic vocal cord paralysis even for more than 9 months without recovery. When such surgery is needed to improve airway ventilation, it is necessary to refer to the advice of a specialist and choose carefully.