I just installed the patch after a clean install of my games and now i can't get the sound or music to run in TR3. The cut scene sound is fine but not the actual game. Any Ideas?

I had the same issue. Just run Tomb Raider 3's Setup and make sure "Primary Sound Driver" is selected in the sound section (Which it should be, as I believe the game's settings are reset to defaults whenever you run the program).

After that, the sound should work fine.

In the setup choose software acceleration.

a bit late to the party but in case anyone is looking through here and goes "well where is setup?" click the start menu and scroll down to the GOG.com folder and then Tomb Raider 1+2+3 and then the Tomb Raider 3 sub folder. For some odd reason the setup file is only there and not in the main game directory.

I'm even later - but have a solution...
experienced the same issue after a standard installation in Win 7 64 Ult.
Locate the Config.txt file in the TR3 folder. Open in a text editor and check that the "Sound" entry is equal to 1. If "Sound=0" as I found, change to "Sound=1" and save. Restart game.

It works !
To be more precise : launch the game first and change the value AFTER, for an unknown reason, before the first start of the game the value is 1 but it changes to 0 once you launched it.