I can't run the patched code at all. Neither with SSCI nor with ScummVM. I'm running a Linux system (so NSIS patching via Wine, not sure if that works), and maybe the patch isn't for the exact version of SQ5 that I have? In any case, I can't investigate for now.
EDIT: Actually, SSCI does run, there's just no sound. And ScummVM bugs out with these messages:
User picked target 'sq5-1' (engine ID 'sci', game ID 'chest')...
WARNING: Could not get volume for resource 0, VolumeID 0!
WARNING: Error 6 occurred while reading text.51969 from resource file resource.000: Unknown compression method!
WARNING: resMan: Failed to read text.51969!
WARNING: Couldn't identify game 'chest' for the engine 'sci'.!
(I cloned the game entry for my original SQ5 copy. I have no idea why it refers to 'chest', which was one of the bonus things they included with later games)