Do you attempt to spare the submandibular glands in head and neck IMRT?

I do too. The primaries I consider electively treating 1B nodal station are: oral cavity, nose and anterior nasal cavity, lip, medial cheek/mid face, and node positive parotid. The submandibular gland itself is devoid of lymph nodes and is rarely ever involved by Sq cell Ca (versus the parotid gland...

There are no lymph nodes in the submandibular gland! Avoiding the gland in the CTV minimizes dose to the oral cavity, which is critical.

I do and I spare as low as possible.