Hey there, ill give you a brief breakdown of what the problem(s) are:

1. Graphical performance was average after installation, however experienced enormous sound lag (as Ive scoured the forums it seems many users have had the same problem). I found the solution in the Silent Hill Homecoming patch v 11 which sync'ed my sound up nicely. This however brought about problem number 2.

2. Since installing the silent hill homecoming patch, and subsequently replacing the .dll with the modified version, the graphical performance has decreased massively, i can no longer survive in a fire fight with more than 2 npcs as the lag is excruciating, its fine out in the field, but when im faced with multiple npcs, it svcks, and i mean like 10 fps svcks. This as i understand it, is to do with NV struggling to optimize the engine which handles expressions etc... in conjunction with the graphics card. So i replaced the Silent Hill Homecoming .dll with the recommended one from these forums for graphical issues (http://www.gamesas.com/index.php?/topic/1134379-d3d9dll-and-why-it-works/), which of course has replaced the Silent Hill Homecoming patch, and as a result, has sent my sound back into ultraz0r lagmode...

...So, you see my dilemma, i have 2 x .Dll's, one of which fixes my original sound lag issues, and the other which fixes my graphical lag issues.

Wondering, hoping that someone has come across a .Dll that fixes both, if you have could you let me know that would be awesome, thanks.

just play your favorite tracks and turn off the sound of FNV. There isn't much to listen to in the game anyway. Or you can just extract few songs out and play them instead. What's the loss, you can still play the game at least.