Hair cell loss is a major cause of sensorineural hearing loss. We have developed a method to examine metabolic events in hair cells in response to stimuli known to cause hair cell loss, such as acoustic trauma and aminoglycoside administration. The method employs two-photon excitation of the metabolic intermediate, reduced nicotinamide adenine dinucleotide (NADH), in hair cell mitochondria in an explanted mouse cochlea. Using this method, we show evidence that the aminoglycoside gentamicin selectively affects the level of mitochondrial NADH in outer hair cells, but not inner hair cells, within minutes of administration.