Prostaglandin D2 synthase is an excellent biomarker for the assessment of cerebrospinal fluid leaks. Maybe the most appropriate cut-off value used for rhinorrhea and otorrhea samples was 0.7 mg/L. Values greater than 2.0 mg/L could be used for spine postoperative fluid leakage samples. The cut off value for βTP in the diagnosis and follow-up of cerebrospinal fluid leaks should be modified depending on the type of secretion (sample type), for a better diagnostic accuracy.