Greetings fellow Eorzean,

I'm sorry to hear about this audio issue that you've been experiencing. Have you tried updating your sound drivers by any chance? Additionally, it might also help to run the game after clean booting your PC to ensure that there aren't any other programs that might be conflicting with the game. To perform a clean boot, please open your Task Manager and navigate to the 'Start Up' tab. From there, disable all applications listed and restart the PC. Once this has been done, please try starting the game up once more to see if there are any changes.

I hope this helps! Thanks for posting in the FINAL FANTASY XIV Technical Support Forums.