Are you tired of having to reset your audio options every time you restart this game? Do you play the game in windowed mode and tired of it always going back to full screen every time you close and re open this game? I have a way for you to fix this and force the game to save your preferences every time.

I discovered this by accident but it works every time I try it.
First, open the game and then go to your options. Adjust your preferences to your desires. I myself like to turn the music all the way off in the game and turn the sound effects very low, as I play this game while listening to podcasts or my own music. I also prefer to have this game windowed.
So adjust the options to how you want, volume, full screen or not, and the graphics settings, gore, cursor, etc. Then, do not close the game, but alt tab if you're full screen or if windowed, go into your computer files.
Go to your C drive, or whatever drive you have your steam games installed on. For most of you, it will be C.
Go to the file Users. then go to your user file. Here you will see a file called AppData. If you don't see it, you will need to go into your folder settings and enable view hidden files. once you see App Data, click into there and go to Roaming. You will see files for various games on your Steam, including Larva Mortus. Go to Larva Mortus.
Here you should see a folder marked "saves", and below it two files titled "prefs.cs" and "orefs.cs.dso".
You must have the game open while doing this for this to work. So while you have Larva Mortus running, delete the two "prefs" files from this folder.
WARNING! Do not delete the Saves folder or you will lose your game progress!
Delete the prefs files, then save your options in the game once more. Now close down the game.
This should generate new prefs files with your saved options.

Now start the game back up and it should have your options now saved so you don't have to reset them every time.


Recap! TLDR!

Start up Larva Mortus
Adjust your options to how you want.
Leave game running.
Go to C:\Users\----\AppData\Roaming\Larva Mortus in your computer.
Delete both "prefs" files.
Go back into Larva Mortus, save your options now.
Close the game.
New preferences are now saved.