Never heard of these things specifically, but isn't Pinball Dreams/Fantasies using common Protracker modules? Most of the sound effects are played with the music still running in background so if I'm not wrong this might use some real time mixing. Another interesting example is Jochen Hippel's 7-voice routine which doubles 3 of the 4 channels and maybe reserves the 4th for interactive stuff like sound effects (I'm not quite sure about this, infos are hard to find). Another interesting one is Deluxe Galaga by Edgar M. Vigdal where the user can decide himself which tracks are used for music or effects and also can add his own modules if he likes.
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