I can confirm the patch works on real hardware, although failed on the original Sound-Blasters I tested.
I had success with the following configuration:
– PCI ESS-Solo1 Soundcard
– SoftMPU
– MT-32
– Copied everything from the CD to C:\SKY\
– Select Roland MT-32 in the sound options.
– Started SKYDRV from C:\SKY. It then enables Sound Blaster support in addition to MT-32.
Other bits and pieces: using XCDROM, CTMOUSE, SHSUCDX and EMM386 in the default configuration.