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Pioneers in skull base surgery revolutionized neurosurgery by developing approaches to treat previously inaccessible tumors through the base of the skull, transitioning from early, high-risk open techniques to modern, minimally invasive methods. Key figures include Francesco Durante (first successful meningioma removal, 1885), M. Gazi Yaşargil (microsurgery revolution), William House (translabyrinthine approach), and Ugo Fisch (petrous bone surgery).