Are you running the game in Directx9 or Directx10? Sometimes it can cause an issue. For example, I am using Windows 7 and I tried to run Crysis in Directx10. But it kept crashing on me and I had to switch to Directx9 in order to make it work properly. Perhaps you suffer from the same problem.
Have you also tried updating the game? There's a patch available for KOTOR2.
I was also able to pull some interesting things from this website:
http://www.tweakguides.com/KOTOR2_3.html
There are a number of things mentioned there that cause Vista crashes with this game, and there's an entire section devoted to audio.
"" Audio Problems: KOTOR 2 has several issues with audio, however there are a few things you can do to minimize these problems. To begin with, make sure in Windows that you go to Control Panel>Sounds and Audio Devices>Advanced, and ensure your speaker setting matches your actual physical speaker setup. Note that sometimes if you crash out of KOTOR 2, these settings may be altered without your knowledge, so check back on these often (and in detail) if you are having audio problems. Then under the Performance tab, you can try reducing the Hardware Acceleration slider one notch to see if it removes some of your audio problems. If you have an EAX-capable sound card and are using any EAX in KOTOR 2, go to your AudioHQ and open the EAX Control Panel. Click the 'All Effects Off' button at the bottom left. Finally, EAX may cause problems on some audio cards regardless of settings, so disable it in the Advanced Audio settings of the game.
Once again note that there are issues with certain sound hardware in KOTOR 2, so check the game's Troubleshooting Guide for more details and recommended solutions/workarounds. ""
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